Therapeutic uses of controlled drugs

Question 1

Historically what has depression research focused on?

Answer 1

> Noradrenalin

> Serotonin

Question 2

SSRIs are typically used in the treatment of depression. What are the flaws associated with them?

Answer 2

> Dependence
> Sexual dysfunction
> Serotonin syndrome
> Suicidal behaviour
> Delayed effect

Question 3

Why do SSRIs have a delayed effect?

Answer 3

> Increasing 5-HT levels may trigger a negative feedback loop
Constant stimulation leads to habituation and decreased sensitivity over 2-4 weeks
Negative feedback reduced, serotonin levels increase

Question 4

What did Hjorth et al (2000) attempt?

Answer 4

To reduce the delayed effect of SSRIs on depression treatment through a series of microdialysis experiments.

Question 5

What did Hjorth et al (2000) find?

Answer 5

That 5-HT autoreceptors are the cause of the delayed effect of SSRIs

Question 6

What effect does ketamine have on depression?

Answer 6

Ketamine has a strong, immediate antipsychotic effect

Question 7

Theoretically, why can ketamine treat depression?

Answer 7

During depression glial cells are lost due to extrasynaptic glutamate. Ketamine increases synaptic transmission and also blocks NMDA receptors

Question 8

What are the drawbacks to using ketamine to treat depression?

Answer 8

> Unknown safety profile
> May cause suicidal ideation rebound
> May accelerate mania
> Unknown long-term cognitive effects
>May cause bladder damage

Question 9

What is Psilocin?

Answer 9

The active metabolite of the psychodelic psilocybin; the psychotropic compound found in magic mushrooms

Question 10

How can psilocin be used to treat depression?

Answer 10

> Hallucinogens have an indirect effect on glutamatergic transmission

Question 11

How can psilocin be used to treat depression?

Answer 11

> Hallucinogens have an indirect effect on glutamatergic transmission
Reduces amygdala reactivity
Immediate increase in 5-HT levels