Week 11c: Mood disorders, Anxiety, Psychosis

Question 1

major depressive disorder

Answer 1

clinical depression as defined by the DSM-5

Question 2

Dysthymia

Answer 2

mild, chronic depression for two or more years

Question 3

bipolar disorder

Answer 3

alternating between manic and major depressive disorder

Question 4

cyclothymia

Answer 4

alternating between hypomanic and mild depressive phases

Question 5

characteristics of depression

Answer 5

• depressed mood
• anhedonia
• feelings of worthlessness of excessive guilt
• decreased concentration
• psychomotor agitation or retardation
• insomnia or hypersomnia
• decreased libido
• change in weight or appetite
• thoughts of death or suicidal ideation

Question 6

PET and MRI findings in bipolar disorder and MDD

Answer 6

show a reduction in the volume of grey matter in the prefrontal cortex with an associated decrease in activity in the region

Question 7

PET and MRI findings in bipolar disorder and MDD: brain regions with decreased regional glucose metabolism

Answer 7

inferior frontal gyrus, bilateral superior and middle temporal gyrus and bilateral anterior cingulate cortex

Question 8

PET and MRI findings in bipolar disorder and MDD: brain regions with increased regional glucose metabolism

Answer 8

bilateral hippocampus and left thalamus

Question 9

4 classes of meds for depression

Answer 9

1. TCAs
2. SSRIs
3. Atypical antidepressants
4. MAOIs

Question 10

prototype drug of TCAs

Answer 10

Imipramine (tofranil)

Question 11

adverse effects of TCAs

Answer 11

• anticholinergic effects
• confusion, drowsiness
• orthostatic hypotension
• sedation
• sexual dysfunction and weight gain

Question 12

what is a major contraindication of TCAs

Answer 12

dysrhythmias and recent MI

Question 13

It may take _____ weeks for TCAs to have a therapeutic effect

Answer 13

2-6 weeks

Question 14

mechanism of action of SSRIs

Answer 14

prevent the reuptake of serotonin by the presynaptic nerve terminals in the limbic system

Question 15

when are the therapeutic effects of SSRIs seen

Answer 15

4-6 weeks

Question 16

SSRIs + TCAs and MAOIs can cause

Answer 16

serotonin excitation syndrome

Question 17

serotonin excitation syndrome symptoms

Answer 17

hyperpyrexia, hypertension, confusion, sweating, tremors, ataxia

Question 18

SSRI discontinuation syndrome

Answer 18

occurs when SSRIs are abruptly stopped

Question 19

Signs and Symptoms of SSRI discontinuation syndrome

Answer 19

• dizziness, confusion
• lethargy
• paresthesia
• vivid dreams
• nausea

Question 20

Prototype drug for MAOIs

Answer 20

Phenelzine (Nardil)

Question 21

MAOIs have equal efficacy as SSRIs and TCAs but…

Answer 21

they have a smaller margin of safety

Question 22

adverse effects of MAOIs

Answer 22

• hepatotoxicity
• orthostatic hypotension
• headache
• insomnia
• diarrhea

Question 23

adverse effects of lithium

Answer 23

• kidney impairment
• dysrhythmias and circulatory collapse
• leukocytosis
• hypothyroidism and goiter (lithium decreases the production of thyroid hormones)

Question 24

what are the 3 brain areas associated with anxiety

Answer 24

1. limbic system
2. reticular formation
3. prefrontal cortex

Question 25

which brain area is associated with emotion, learning and memory

Answer 25

limbic system

Question 26

stimulation of the reticular formation increases?

Answer 26

arousal and alertness

Question 27

inhibition of the reticular activating system promotes?

Answer 27

drowsiness and sleep

Question 28

side effects of short term use of benzodiazepines

Answer 28

- aggression - dizziness - drowsiness - sexual dysfunction - depression - blurred vision

Question 29

side effects of long term use of benzodiazepines?

Answer 29

- cognitive problems - sleep disturbances - mental disorders - immune system suppression - cancer risk - addiction

Question 30

neurotransmitter imbalance in psychosis

Answer 30

overactive dopaminergic pathways in the basal nuclei leads to overstimulation of dopamine type 2 receptors

Question 31

blocking of the dopamine receptors can produce?

Answer 31

EPS, similar to what happens in PKD

Question 32

muscle spasms of the back, neck and tongue at onset of treatment

Answer 32

acute dystonia

Question 33

akathisia

Answer 33

restlessness

Question 34

unusual tongue and face movements associated with long-term use

Answer 34

Tardive dyskinesia

Question 35

neuroleptic malignant syndrome signs and symptoms

Answer 35

- high fever, diaphoresis - muscle rigidity - tachycardia, blood pressure fluctuations

Question 36

treatment for NMS

Answer 36

muscle relaxants and antipyretics