Psychophramacology/antidepressants Flashcards
Overall effectiveness of antidepressants
65-70%
Mild to moderate depressive episodes
SSRIs
Severe depression:
Antidepressants with broader spectrum of effects, like SNRIs.
When can therapeutic effect be observed?
it might take 2-4 weeks before therapeutic effect is observed.
to prevent recurrence?
Treatment usually last for 6+ months, to prevent relapse of symptoms. however, treatment may be needed for a longer time (1year or more).
TCAa
(Classes of antidepressant medications)
= Tricuclics
Broad mechanism of action, they tend to cause more side effects than the other classes of antidepressants
SSRIs
(Classes of antidepressant medications)
= selective serotonin reuptake inhibitors
Increase serotonin in the brain by blocking “serotonin reuptake” in the brain
SNRIs
(Classes of antidepressant medications)
= serotonin and norepinephrine reuptake inhibitors
Block the “reuptake” of both serotonin and norepinephrine
NDRIs
(Classes of antidepressant medications)
= nmorepeinephrine and dopamine reuptake inhibitors
Increase the levels of norepinephrine and dopamine b blocking their “reuptake” in the brain
RIMAs
(Classes of antidepressant medications)
= reversible inhibitors of monaminsae A enzyme
Inhibits the enzyme that breaks down the monoamine molecules in the synaptic cleft
SSRIs side effect
- apathy
- nausea/vomiting
- Drowsiness
- Headache
- extremly vivid and strange dreams
- WEIGHT GAIN (marked in red in pp)
- dizziness
- fatigue
- CHANGES IN SEXUAL BEHAVIOR
- suicidal thoughts
Many disappear within 4 weeks (adaption phase)
Serotonin-norepeniephrine reputake inhibitors (SNRIs)
- slightly greater efficacy than SSRIs
- Slightly fewer adverse effects than SSRI
- Mechanism of action (similar to SSRIs)
- Side effects (similar to SSRI + suicide)
Current drugs:
- veneflaxine (effexor)
- Duloxetine (cymbalta)
Norepinephrine-dopamine reuptake inhibitors (NDRIs)
Current drugs:
- bupropion
Mechanisms of action
- similar to SSRIs and SNRIs
- more potent in inhibiting dopamine
Adverse effects:
- lower seizure threshold
- suicide
- does not cause weight gain or sexual dysfunction
Treatment phases of depression
6 months:
- Acute phase: down period with a slight up-period (improvement)
- Continuation: response (the transmission from actor to continuation.
12 months:
- Maintance: remission + recurrence
THx of OCD
First-line pharmacological treatment: - SSRI Administration of medium to high doses - Acute treatment of at least 3 months - if efficacious, maintenance treatment of at least 1 year
