T3 L2: Affective disorders - neurobiology and treatment Flashcards
What are some factors that cause decrease in serotonin and lead to depressive syndrome?
Adverse childhood experiences
Current stress
Genetic factors
Neuroplasticity, neuroinflammation, and cortisol levels also have an influence
Which monoamine causes depressive symptoms of sadness, suicidal ideation, guilt, feelings of worthlessness?
Serotonin
Which monoamine causes energy symptoms of depression?
Noradrenaline
Which monoamine causes depressive symptoms of lack of motivation and sociability?
Dopamine
What is the subgenual cingulate cortex for?
For emotion regulation and processing
Which neurotransmitters are behind chronic stress/depression?
Decreased GABA and glutamate
What are MAOi drugs and how do they work?
They are monoamine oxidase inhibitors and they non-selectively inhibit enzymes involved in the breakdown of monoamines like serotonin, dopamine, and norepinephrine
They are a type of antidepressant
How do tryciclic antidepressants work?
The non-selectively inhibit the reuptake of monoamines like serotonin, dopamine, and norepinephrine
Give examples of 1st generation antidepressants
MAOi’s and tryciclic antidepressants
Give examples of 2nd generation antidepressants
SSRI’s, SNRI’s (serotonin-noradrenaline reuptake inhibitors), alpha-2 and 5-HT antagonist, dopamine-noradrenaline reuptake
What are some side-effects of using SSRI’s?
Gastro-intestinal (nausea, diarrhoea) Headache Irritability Anxiety Reduction in libido and sexual dysfunction
What are some side effects of tryciclic antidepressants?
Constipation Orthostatic hypotension Dry mouth Drowsiness Cardiac toxicity in overdose
What are some side effects of MAOi’s?
Dry mouth GI effects Headache Drowsiness Insomnia Dizziness Food interactions
What is the difference in short-term and long-term treatment of bipolar disorder?
Short: Reduce severity and shorten the duration of the acute episode and achieve remission of symptoms
Long: Prevention of new episodes and to achieve adequate inter-episode control of residual or chronic mood symptoms
What are the drug categories used to treat bipolar disorders?
Lithium
Antipsychotics
Anticonvulsants
Antidepressants
