SB L1 - Monoamines 1 - Hypothesis Revisited

Question 1

3 core elements of anxiety disorders

Answer 1

negative cognition
physiology
avoidance behaviour

Question 2

existing anxiety treatments

Answer 2

BZ
brspirone
SSRIs
B-blockers
Atypical antipsychotics
CBT

Question 3

How do BZa work/ what is the problem?

Answer 3

at GABA-A-R - fast acting but dependence problems

Question 4

Dianosis of depression according to DSM criteria

Answer 4

Depressed mood most of the day or diminised interest/pleasure in everyday activity

+ 4 or more symptoms from the list

Question 5

3 Causes of depression?

Answer 5

Biological vulnerability (e.g. gender, genetics)
Exogenous stressors (e.g. early life trauma)
Mood regulatory circuits (e.g. connectivity, chemistry)

Question 6

What gender is more likely to get depression?

Answer 6

Females

Question 7

3 classes of antidepressants and how they have evolved?

Answer 7

MAOIs - now have selective to overcome cheese reaction
TCAs - 5HT selective (SSRIs) and NA targetting (SNRI). Dual acting on DA/NA (bupropion)

Receptor blockers - mirtazipine, nefazodone

Question 8

All available drugs on the market target ……..

Answer 8

monoamines

Question 9

Role of NA

Answer 9

attention, mood, sleep,

loss of pleasure, drive, appetite

Question 10

Role of DA

Answer 10

loss of pleasure, drive, appetite,

Question 11

Role of 5HT

Answer 11

anxiety, obsessions, negative cognition

mood, sleep,

loss of pleasire

Question 12

5 Limitations of existing antidepressants

Answer 12

Efficacy
Tolerabiltiy
Time to onset
Discontinuation effects
Saftey

Question 13

Existing antidepressants:

efficacy issues

Answer 13

q

Question 14

Existing antidepressants:

efficacy issues

Question 15

Existing antidepressants:

tolerability issures

Answer 15

S/e profile deters use - emotional blunting and detachment with SSRIs

Question 16

Existing antidepressants:

time to onset

Answer 16

4-6 week before therapeutic benifit

Question 17

Existing antidepressants:

discontinuation effects

Answer 17

must taper off use

Question 18

Existing antidepressants:

safety issues

Answer 18

risk of suicide is controversial - lack of efficacy or treatment response where previously could not take action?

Question 19

Ideal antidepressant properties

Answer 19

Response
Remission
Increased time between episodes
Rapid effect

Question 20

Ideal antidepressant properties

Answer 20

Response
Remission
Increased time between episodes
Rapid effect

Question 21

Pharmacological activity of buspirone

Answer 21

agonist of 5-HT1AR

Question 22

What gene linked with expression of 5-HT1A

- Ref

Answer 22

Polymorphisms in the human 5-HT1A receptor promoter regulating expression levels
(Lesch & Gutknecht, 2004)

Question 23

Evidence of importance of 5HT1A receptor in humans

-Ref

Answer 23

Decreased 5-HT1A receptor expression in panic disorder patients

(Neumeister et al. 2004)

Question 24

Advantages of buspirone over BZs?

Answer 24

as effective
as fast acting

no withdrawl symtpoms

Question 25

2 compounds related to Busiprone

Answer 25

gepirone

ipsapirone