Pharmacology of Mood Disorders

Question 1

Mood disorder

Answer 1

a persistent disturbance in emotion that impairs ability to effectively deal w/ADL’s

Question 2

depression

Answer 2

sad/despondent mood out of proportion to actual life events; most common mental health disorder; S/S: lack of energy, sleep disturbance, abnormal eating patterns, feeling of despair, guilt, hopelessness, may have suicidal tendencies; CAN have psychotic features

Question 3

antidepressants

Answer 3

restore normal neurotransmitter balances to brain (mainly norepinephrine, serotonin, & dopamine); SSRI’s, atypical, TCA’s, and MAOI’s

Question 4

selective serotonin reuptake inhibitors (SSRI’s)

Answer 4

preferred drugs for treating depression due to their low incidence of serious adverse effects; simpathomimetic effects, anticholinergic effects, sedation, sexual dysfunction, and weight gain

Question 5

serotonin syndrome

Answer 5

serious medical condition that can occur when a patient takes multiple medications that cause serotonin to accumulate in CNS; S/S: confusion, restlessness, anxiety, agitation, HTN, tremors/muscle rigidity, sweating, fever, and ataxia; TX: discontinue all serotonergic drugs

Question 6

fluoxetine (Prozac)

Answer 6

antidepressant, anti anxiety agent, SSRI
USE: depression, bulimia, panic attacks, premenstrual dysmorphic disorder, OCD
MOA: blocks uptake of serotonin at neuronal presynaptic membrane; enhances serotonin action
AE: n/v/d, headache, anorexia, fluctuations in weight, sexual dysfunction, seizures, constipation, poor concentration, hot flashes, serotonin syndrome, nervousness
BLACK BOX WARNING: suicidal ideation
Caution: pt’s w/hypersensitivity, bipolar disorder, cardiac dysfunction, diabetes, & seizure disorders
Drug interactions: MAOI’s & drugs metabolized by CYP450
Pregnancy: risks to baby; use only if benefits outweigh risks

Question 7

atypical antidepressants

Answer 7

alternatives to SSRI’s; “miscellaneous” class because these drugs have little in common w/each other; SNRI’s, NDRI’s, NRI’s, etc

Question 8

venlaxafine (Effexor)

Answer 8

atypical antidepressant, SNRI
USE: major depression, panic disorder, GAD, social anxiety disorder, & off label
MOA: inhibits presynaptic neuronal reuptake of both norepinephrine and serotonin in CNS
AE: nausea, anorexia, weight loss, CNS stimulation, BP elevation, and sexual dysfunction
BLACK BOX WARNING: suicidal ideation
Drug interactions: drugs that inhibit CYP2D6 can cause serum levels to rise
Pregnancy: only if benefits outweigh risks

Question 9

tricyclic antidepressants

Answer 9

once mainstay for depression treatment; have many adverse effects; block reuptake transport of norepinephrine and serotonin; anticholinergic effects, orthostatic hypotension, sedation, sexual dysfunction, withdrawal symptoms (if not tapered)

Question 10

imipramine (Tofranil)

Answer 10

tricyclic antidepressant, norephinephrine inhibitors
USE: major depressive disorder & off label
MOA: blocks reuptake of norephinephrine and serotonin; blocks Ach receptors
AE: tricyclic antidepressant effects + jaundice, photosensitivity, pruritis, rash, and increased appetite
BLACK BOX WARNING: suicidal tendencies
Precautions: seizure disorders, suicidal tendencies, urinary retention, prostatic hyperplasia, cardiac/hepatic disorders, etc
Drug-drug interactions
Pregnancy: risk to baby