Pharmacology of Mood Drugs

Question 1

Name some MAOI’s

Answer 1

phenelzine

isocarboxazid

tranylcypromine

Question 2

Depression = hyposerotonism

true/false?

Answer 2

false - the brain is not just out of balance in mental illness, requiring more of an ingredient.

Question 3

Where do MAOI’s act?

Answer 3

the presynaptic nerve terminal

Question 4

Where do TCA’s act?

Answer 4

the synaptic cleft

Question 5

Where do SSRI’s act?

Answer 5

the presynaptic nerve terminal

Question 6

what is 5-hydroxytryptamine

Answer 6

serotonin

Question 7

What are some examples of SSRI’s?

Answer 7

citalopram, fluoxetine, paroxetine, escitalopram, sertraline

Question 8

How do SSRI’s work?

Answer 8

inhibit the reuptake of serotonin - increases synaptic 5-HT in hours

Question 9

How long do SSRI’s take to improve mood?

Answer 9

2-3 weeks

Question 10

Which SSRI’s inhibit CYP450?

Answer 10

fluoxetine, paroxetine

Question 11

SSRI’s are dangerous in overdose - true or false

Answer 11

False, they are relatively safe.

Question 12

What side-effects are commonly seen in SSRI’s?

Answer 12

Sexual dysfunction

GI - nausea, dyspepsia, constipation

Short term anxiety

Question 13

What happens to self harm and suicide risk in young patients in the first few weeks of SSRI treatment?

Answer 13

Increased risk of self-harm and suicide

Question 14

What are some TCA side-effects?

Answer 14

constipation

dry mouth

blurred vision

cardiac effects - postural hypotension

Question 15

How do TCA’s cause postural hypotension?

Answer 15

cholinergic and adrenergic blockade causes failure of peripheral orthostatic reflexes

Question 16

how do MAOI’s work?

Answer 16

inhibiting the enzyme monoamine oxidase

Question 17

What effect do MAOI’s have on 5-HT and NA availability?

Answer 17

increased storage and availability for release

Question 18

Which subtype of depression is often treated with MAOI’s?

Answer 18

Atypical depression

Question 19

What are some adverse effects of MAOI’s?

Answer 19

hypertensive crises from tyramine containing foods (cheese, yoghurt, meat, alcohol)

Drug interactions

Question 20

How do you treat MAOI adverse effects?

Answer 20

alpha blockade

• phentolamine, chlorpromazine

Question 21

Where is dopamine produced?

Answer 21

substantia nigra

Question 22

Which antidepressant can cause extra-pyramidal side-effects?

Answer 22

paroxetine

Question 23

GABA is responsible for excitatory actions - T/F?

Answer 23

false - GABA is the main inhibitory neurotransmitter

Question 24

What are the different classes of drugs commonly used as mood stabilisers?

Answer 24

Anti-convulsants - carbamazepine, lamotrigine, valproate

atypical antipsychotics
-olanzapine, risperidone, aripiprazole, quetiapine

others (lithium) and nimodipine

Question 25

How does lamotrigine act?

Answer 25

blocks Na+ channels

reduces overall excitability and cell firing

Question 26

Lithium is safe in overdose - T/F?

Answer 26

false - lithium is toxic in overdose and requires blood monitoring

Question 27

Why does lithium require blood monitoring?

Answer 27

Can induce renal problems - check U&E’s

Question 28

What is the mechanism of action of first generation anti-psychotics in mood stabilisation?

Answer 28

affinity for the D2 receptor

Question 29

What is the mechanism of action of second generation antipsychotics in mood stabilisation?

Answer 29

1. Increased D2 receptor-binding affinity increases antipsychotic effectiveness
2. Increased 5-HT2C and 5-HT2A receptor-binding affinities increase antipsychotic efficacy
3. Increased 5-HT1A receptor-binding affinity reduces antipsychotic efficacy