Test 4: Affective Disorders Flashcards
A person affected by this type of bipolar has had at least one manic episode in their life
bipolar I
A person affected by this type of bipolar has moods cycling between high and low, but the “up” moods never reach full on mania
bipolar II
In this type of bipolar, a person experiences 4+ episodes of mania or depression in one year
rapid cycling
in this type of bipolar, a person experiences both mania and depression simultaneously or in rapid sequence
mixed bipolar
this mood disorder is like bipolar, but has milder symptoms
cyclothymia
Genetics contributes __% to mood disorders
40-50
Genetics contributes __% to bipolar disorder
60-70
Which neurotransmitters modulate the ability of hypothalamic neurons to secrete corticotropin releasing factor?
GABA, NE, Ach
CRF increases the secretion of ___ from pituicytes in the anterior pituitary into the blood
ACTH
ATCH acts upon the ___ glands to increase release of cortisol
adrenal
cortisol normally [turns on/off] the stress response
off
Depressed patients have [increased/decreased] cortisol secretion in response to [increased/decreased] ACTH release
increased, increased
MAOIs and TCAs both [increase/decrease] biogenic amines
increase
common way to determine 5HT function is by measuring levels of metabolite __
5HTIAA
[lower/higher] amount of 5HTIAA in brain of depressed patients
lower
___ levels in blood measure 5HT function
tryptophan
unmedicated depression patients have an [increased/decreased] density of postsynaptic 5HT2
increased
amygdala [increase/decrease] correlates with severity of depression
increase
Acute ADs increase 5HT by [inhibiting/exciting] MAO
inhibiting
Chronic ADs result in pharmacodynamic [up/down regulation] of 5HT autoreceptors
down
T or F: polypharmacy is frequently used to increase clinical outcomes of affective disorders
true
Increase in clinical outcomes occurs usually __ weeks into AD treatment
4-6
MAO normally metabolizes which 3 monoamines not packaged into vesicles?
NE, DA, 5HT
[Excitation/Inhibition] of MAO increases amount of monoamines available for packaging and release
inhibition
In which two places does MAO mechanism of action occur?
synaptic terminal and cleft
Though one dose of MAOI can increase monoamine release, clinical effects are not seen for weeks - suggests that alterations in receptor ___ and ___ or 2nd messenger signaling are responsible for clinical efficacy
density and activity
4 common side effects of MAOIs
changes in BP, sleep, appetite, weight gain
Dangerous MAOI side effects occur from MAO inhibition in ___
liver
TCAs are closely related to what type of drugs?
antipsychotics
TCAs bind to ___ to [inhibit/increase] uptake into presynaptic terminal
reuptake pumps, inhibit
TCAs prolong action at ___
synapse
TCAs act on __ and __
SERTs and NERTs
Because of TCA affinity for Ach, 3 common side effects are
dry mouth, dizziness, confusion
Because of TCA affinity for histamine receptors, a common side effect is
sedation/fatigue
Dangerous TCA side effects come from affinity for ___ receptors
a1 NE
SSRIs have [greater/weaker] affinity for SERT than TCA
greater
T or F: SSRIs have greater affinity for NERTs than SERTs
false
4 common side effects of SSRIs
restlessness, insomnia, nausea, sexual dysfunction
dangerous side effect of SSRIs is called
serotonin syndrome
SSRIs [do/do not] have dependence problems
do
Atypical ADs either block ___, __/___, or __/___
NERTs, SERTs/NERTs, or NERTS/DATs
T or F: side effects of atypical ADs are similar to SSRIs
true
2 major classes of pharmacotherapies for bipolar
lithium and anticonvulsants
__ weeks on lithium eliminates or reduces manic episodes
2
lithium enhances ___ action
5HT
lithium [increases/decreases] catecholamine action
decreases
5 common side effects of lithium
thirst, urination, impaired concentration, fatigue, tremor
Where in the body is lithium toxicity problematic?
kidneys
first anticonvulsant approved by FDA for mania treatment
valproate (depakote)
Depakote increases GABA by stimulating __ and inhibiting __
GAD, GABA transaminase
dangerous side effects of depakote
liver toxicity and pancreatitis
Carbamazepine (Tegretol) blocks __ channels on __ presynaptic terminals
NA, GLU
Tegretol [increases/decreases] GLU release
decreases
Tegretol common side effects
sedation, dizziness, incoordination, nausea
Tegretol dangerous side effects
liver toxicity, blood diseases