Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Psychiatry > Pharmacology of Antidepressants and Mood Stabilisers > Flashcards

Pharmacology of Antidepressants and Mood Stabilisers Flashcards

1
Q

What is the MOA of monoamine oxidase inhibitors (MAOIs)?

A

Slows down the breakdown of NA, 5-HT and DA by inhibition of the mitochondrial enzyme monoamine oxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the MOA of antidepressants generally?

A

Blocking reuptake of monoamine neurotransmitters (5-HT, NA,DA)
Preventing breakdown of monoamine neurotransmitters
In short term increased neurotransmitter availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are Na selective antidepressants?

A 
Maprotiline
Desipramine
Reboxetine
Protriptyline
Nortriptyline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are non-selective antidepressants?

A

Amitriptyline
Imipramine
Clomipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 5-HT-selective antidepressants?

A 
Venlafaxine
Paroxetine
Fluvoxamine
Sertraline
Fluoxetine
Citalopram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the appetitive/approach systems in the brain?

A

Function to mediate seeking and approach behaviours (incl. pleasure)
Ascending dopamine systems- mesolimbic/cortical projection
Ventral striatum
Dorsal striatum (movement)Amygdala (conditioning/learning)
Anterior cingulate (attention/ conflict/
response selection)
Orbitofrontal cortex (relative reward preference/ rule learning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the aversive/defensive systems in the brain?

A 
Function to promote survival in event of threat (fear/pain)
Ascending serotonin systems
Na/CRF/Peptide transmitters
Central nucleus of amygdala
Hippocampus
Ventroanterior and medial hypothalamus
Periaqueductal gray matter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the 5-HT1 receptor

A

Found in CNS and blood vessels
Inhibitory effect
Agonists: Quetiapine and trazodone
Antagonists: Nefazodone, Vortioxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the 5-HT2 receptor

A

Found in blood vessels, CNS, PNS, GIT, platelets, smooth muscle
Excitatory effect
Agonists: LSD, mescaline
Antagonists: Most atypical antipsychotics, Mirtazapine, Agomelatine, Fluoxetine, Paroxetine, Nefazodone, Trazodone, Mianserin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the 5-HT3 receptor

A

Found in CNS, PNS, GIT
Excitatory effect
Agonist: Quizapine
Antagonists: Mianserin, Clozapine, Mirtazapine, Olanzapine, Quetiapine, Vortioxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the 5-HT4 receptor

A

Found in the CNS, PNS,GIT
Excitatory effect
No agonists/antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the 5-HT5 receptor

A

Found in CNS
Inhibitory effect
No agonists/antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the 5-HT6 receptor

A

Found in the CNS
Excitatory effect
No agonists
Antagonists: Amitriptyline, Clomipramine, Clozapine, Olanzapine, Aripiprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the 5-HT7 receptor

A

Found in CNS, GIT, blood vessels
Excitatory effect
Agonist: Aripiprazole
Antagonists: Amitriptyline, Clomipramine, Mirtazapine, Vortioxetine, Clozapine, Olanzapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 5-HT receptor types are involved in mood?

A

5-HT 1A,B,2A,C,4,6,7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What 5-HT receptor types are involved in sleep?

A

5-HT 1A,2A,2B,5A,7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 5-HT receptor types are involved in appetite?

A

5-HT 1A,2A,2B,2C,4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What 5-HT receptor types are involved in anxiety?

A

5-HT 1A,1B,1D,2A,2B,2C,3,4,6,7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What 5-HT receptor types are involved in aggression?

A

5-HT 1B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What 5-HT receptor types are involved in memory?

A

5-HT 1B,2A,3,4,6,7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What 5-HT receptor types are involved in learning?

A

5-HT 1B,2A,3,4,6,7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 5-HT receptor types are involved in addiction?

A

5-HT 1B,2C,3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are drugs used for that act on the 5-HT1A receptor?

A

Antidepressant
Anxioytic e.g. buspirone
Psychosis (-ve symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are drugs used for that act on the 5-HT1B receptor?

A

Migraine eg triptans

25
What are drugs used for that act on the 5-HT1D receptor?
Migraine eg triptans
26
What are drugs used for that act on the 5-HT2A receptor?
Atypical antipsychotics | Antidepressants
27
What are drugs used for that act on the 5-HT2B receptor?
Some antidepressants e.g. agomelatine | Some antipsychotics e.g. asenapine
28
What are drugs used for that act on the 5-HT2C receptor?
Antidepressants | Antipsychotics
29
What are drugs used for that act on the 5-HT3 receptor?
Anti-emetics Some antidepressants e.g. mirtazapine, vortioxetine Some antipsychotics e.g. clozapine, olanzapine
30
What are drugs used for that act on the 5-HT4 receptor?
GI pro-kinetic (IBS, chronic constipation)
31
What are drugs used for that act on the 5-HT5 receptor?
None known
32
What are drugs used for that act on the 5-HT6 receptor?
Antidepressants | Anxiolytics
33
What are drugs used for that act on the 5-HT7 receptor?
Antidepressants | Anxiolytics
34
What are some SSRIs?
Fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine
35
What are SSRIs used to treat?
Depression, panic disorder, social anxiety disorder, PTSD, OCD, chronic pain, eating disorders, stroke recovery, premature ejaculation
36
What is the MOA of SSRIs?
By inhibiting the re-uptake of 5-HT, increase synaptic 5-HT within hours Effect takes 2-3 weeks however to improve mood
37
What may be a mechanism that causes the delayed effect of most antidepressants?
5-HT1A receptors- autoreceptors found throughout the CNS that are inhibitory
38
What are the clinical aspects of SSRIs?
Almost all can be started at therapeutic dose from day 1 Tolerated well Safe in overdose Some (fluoxetine, paroxetine) inhibit CYP450 which causes interactions with other drugs that are metabolised via the same pathways
39
What are some adverse effects of SSRIs?
Sexual dysfunction (can be via DA blockade and/or 5-HT2 activation, can be reversed by 5-HT2 antagonists or 5-HT1A partial agonists) GI S/E- nausea, dyspepsia, constipation, diarrhoea Short term anxiety In <25yo, increased risk of self harm and suicide in first few weeks
40
What may patients at higher doses of TCAs need?
ECGs (QTc)
41
What are the adverse effects of TCAs?
``` Constipation Dry mouth Blurred vision Effects on cardiac function Postural hypotension (cholinergic and adrenergic blockage causing failure of peripheral orthostatic reflexes) ```
42
What does MAO A metabolise?
NA, 5-HT and tyramine
43
What does MAO B metabolise?
DA, tyramine and phenylethylamine
44
When are MAOIs often used?
Treatment of atypical depression
45
What are the adverse effects of MAOIs?
Tyramine inactivated in gut by MAO (it acts by releasing NA) HT crisis can occur with tyramine-containing foods (cheese, yoghurt, yeast extracts, meat, alcohol, broad beans, pickled herring) and some drugs (sympathomimetics (including OTC cold remedies), pethidine) Symptoms: flushing, headache, increased BP, rarely CVA
46
What is an MAOI HT crises treated with?
Alpha blockade (phentolamine, chlorpromazine)
47
Describe GABA (A)
Ligand gated ion channel Agonists: Ethanol, benzos, propofol, anaesthetics Antagonists: Flumazenil
48
Describe GABA (B)
GPCR- opens ion channels via intermediate G-proteins Agonists: Baclofen, propofol No antagonists
49
What are some GABA-transaminase inhibitors?
Phenelzine, Valproate, Vigabatrin
50
What are some GABA analogues?
Pregabalin | Gabapentin
51
What are mood stabilisers?
Most are anti-convulsants | More effective at reducing manic episodes than depressive episodes
52
What are some types of mood stabiliser?
Anti-convulsants: carbamazepine, valproate, lamotrigine Atypical antipsychotics: olanzapine, risperidone, aripiprazole, quetiapine Others: lithium carbonate, nimodipine (CCB)
53
How do mood stabilisers likely exert their effects?
By increasing inhibitory neurotransmission in the brain
54
Describe Lamotrigine
Blocks Na channels Overall effect is to reduce excitability and cell firing May also inhibit 5-HT, NA, DA uptake as well
55
What are the MOAs of lithium?
``` Inhibition of 5-HT autoreceptors Increase in anti-apoptotic factor Bcl-2 Increase in glycogen synthase kinase-3 (GSK-3) Depletion of inositol Upregulation of glutamate re-uptake ```
56
Describe lithium in clinical practice
High incidence of adverse effects and toxicity Toxicity in overdose Poor adherence Requires blood monitoring
57
What is the MOA for typical antipsychotics?
Affinity for D2 receptor DA blockade in mesolimbic circuits Adverse effects (movement disorders, hyperprolactinaemia) due to DA blockage in the nigrostriatal and tubero-infundibular pathways respectively
58
What are the main MOAs for atypical antipsychotics?
Increased D2 receptor-binding affinity increases antipsychotic effectiveness Increased 5-HT2C and 5-HT2A receptor binding affinities increase antipsychotic efficacy Increased 5-HT1A receptor binding affinity reduces antipsychotic efficacy

Psychiatry (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions