Week 5.3: An introduction to the psychopharmacology of mood disorders

Question 1

How do neurons communicate?

Answer 1

Neurons communicate via neurotransmitters and receptors.

Question 2

Chemical messengers released by neurons to send signals to other neurons.

Answer 2

Neurotransmitters

Question 3

Proteins on the surface of neurons that bind to neurotransmitters.

Answer 3

Receptors

Question 4

The neuron receiving the signal.

Answer 4

Post-synaptic Neuron

Question 5

When neurotransmitters attach to receptors on the post-synaptic neuron.

Answer 5

Receptor Binding

Question 6

Open or close in response to neurotransmitter binding.

Answer 6

Ligand-gated Receptors

Question 7

Activate internal cell processes when bound by neurotransmitters.

Answer 7

G-Protein Linked Receptors

Question 8

What are the types of receptor binding?

Answer 8

Excitatory: Increases the firing rate of the post-synaptic neuron.

Inhibitory: Decreases the firing rate of the post-synaptic neuron.

Modulatory: Alters the effects of other neurotransmitters or second messenger systems.

Question 9

Medications that alter brain function by changing neurotransmitter activity.

Answer 9

Mood Disorder Drugs

Question 10

What are the types of mood disorder drugs?

Answer 10

Agonists: Drugs that mimic neurotransmitters and activate receptors.

Antagonists: Drugs that block receptors and prevent neurotransmitter binding.

Question 11

What are some examples of mood disorder drugs?

Answer 11

SSRI antidepressants: Increase levels of serotonin in the synapse.

Antipsychotics: Block dopamine D2/3 receptors.

Question 12

The junction between two neurons where neurotransmitters are released.

Answer 12

Synapse

Question 13

The primary excitatory neurotransmitter in the brain, crucial for synaptic plasticity and cognitive functions like learning and memory.

Answer 13

Glutamate

Question 14

The main inhibitory neurotransmitter, which reduces neuronal excitability and helps regulate muscle tone.

Answer 14

GABA (Gamma-Aminobutyric Acid)

Question 15

What are the monoamine neurotransmitters?

Answer 15

Dopamine: Involved in reward, motivation, and motor control.

Serotonin (5-HT): Regulates mood, appetite, and sleep.

Noradrenaline (Norepinephrine): Influences attention, arousal, and the fight-or-flight response.

Question 16

Involves neurotransmitters like anandamide, which bind to cannabinoid receptors; THC (from cannabis) also binds to these receptors.

Answer 16

Endocannabinoid System

Question 17

Shows promising effects on depression by targeting the glutamate system.

Answer 17

Ketamine

Question 18

A neurotransmitter that increases the likelihood of the post-synaptic neuron firing.

Answer 18

Excitatory Neurotransmitter

Question 19

A neurotransmitter that decreases the likelihood of the post-synaptic neuron firing.

Answer 19

Inhibitory Neurotransmitter

Question 20

Intracellular signaling pathways activated by neurotransmitter-receptor interactions.

Answer 20

Second Messenger Systems

Question 21

Can you walk me through the evolution of pharmacotherapies for mood disorders?

Answer 21

1940s:
Electroconvulsive Therapy (ECT)

Mid-1950s:
Lithium

Mid-1960s:
Monoamine Oxidase Inhibitors (MAOIs)

1980s:
Anticonvulsants

1990s:
Second-Generation Antidepressants

Mid-2000s:
Next-Generation Antipsychotics

Question 22

1940s
One of the earliest treatments for mood disorders.

Answer 22

Electroconvulsive Therapy (ECT)

Question 23

Mid-1950s
Became available as a mood stabilizer.

Prevents manic relapse.

May reduce the risk of suicide.

Answer 23

Lithium

Question 24

Mid-1960s
The first antidepressants.

Answer 24

Monoamine Oxidase Inhibitors (MAOI)

Question 25

Introduced in the1980s Such as carbamazepine, lamotrigine, and valproate, used as mood stabilizers.

Answer 25

Anticonvulsants

Question 26

1990s Including SSRIs (e.g., fluoxetine) and SNRIs (e.g., venlafaxine).

Answer 26

Second-Generation Antidepressants

Question 27

Why is it crucial to target the serotonin system in mood disorders?

Answer 27

Lowering Serotonin: Induces depression in people with mood disorders and their relatives. Increasing Serotonin: Can produce manic symptoms. Medications: SSRIs and atypical antipsychotics work by altering the serotonin system.

Question 27

Mid-2000s Such as quetiapine, olanzapine, and aripiprazole, used for mania and bipolar depression.

Answer 27

Next-Generation Antipsychotics

Question 28

How does the serotonin system look like in a healthy brain?

Answer 28

Serotonin Neurons: Located in the raphe nucleus. Projections: Extend to many brain areas, including the subgenual cingulate and the limbic system, which are important for mood regulation.

Question 29

Increase synaptic serotonin levels by inhibiting the serotonin transporter. Ex. Citalopram: 20-40 mg/day. Sertraline: 50-200 mg/day. Fluoxetine (Prozac): 20-60 mg/day.

Answer 29

Selective Serotonin Reuptake Inhibitors (SSRIs)

Question 30

Increase both serotonin and noradrenaline levels by inhibiting their respective transporters. Ex. Venlafaxine (Effexor): 75-375 mg/day. Duloxetine (Cymbalta): 60 mg/day

Answer 30

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Question 31

Mechanism: Blocks 5-HT3 and 5-HT7 receptors, stimulates 5-HT1A receptor. Dosage: 10-20 mg/day. Benefits: May improve cognitive impairment through 5-HT7 blockade.

Answer 31

Vortioxetine (Brintillex)

Question 32

A procedure where electric currents are passed through the brain to treat severe depression.

Answer 32

Electroconvulsive Therapy (ECT)

Question 33

A class of antidepressants that inhibit the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin and dopamine.

Answer 33

Monoamine Oxidase Inhibitors (MAOIs)

Question 34

What is dopamine's role?

Answer 34

Increased Dopamine: Can produce effects similar to mania. Reduced Dopamine: Improves manic symptoms but can worsen depression. Reward and Impulsivity: Mediated by dopamine, often abnormal in mood disorders.

Question 34

A dopamine pathway involved in cognition and mood regulation.

Answer 34

Mesocortical Pathway

Question 34

A dopamine pathway involved in reward and psychosis.

Answer 34

Mesolimbic Pathway

Question 35

Drugs that block dopamine receptors to reduce dopamine activity.

Answer 35

Dopamine Antagonists

Question 36

A dopamine pathway involved in movement control.

Answer 36

Nigrostriatal Pathway

Question 37

A dopamine pathway that regulates prolactin secretion.

Answer 37

Tuberoinfundibular Pathway

Question 38

Is a hormone produced by the pituitary gland, which is located just below the brain. It plays several important roles in the body, including: Lactation Breast Tissue Development Regulation of Prolactin Levels High levels can cause issues like: Erectile Dysfunction Irregular Periods Infertility

Answer 38

Prolactin

Question 38

Mania has been conceptualised as being caused by increases in dopamine in this system.

Answer 38

Nigro Limbic System

Question 39

Used to treat manic symptoms and as mood stabilizers. Some are used for depressive episodes in bipolar disorder.

Answer 39

Antipsychotics

Question 40

What are examples of antipsychotics?

Answer 40

Quetiapine: Uses: Prevents manic episodes and depressive recurrence. Receptors Blocked: Dopamine D2 and 5-HT2A receptors. Olanzapine: Uses: Treatment of mania and bipolar depression. Receptors Blocked: Dopamine D2, 5-HT2A, histamine H1, and alpha-1 receptors. Aripiprazole: Uses: Prevents manic relapse. Mechanism: Dopamine stabilizer, blocks 5-HT2 receptors, and has partial effects on 5-HT1A receptors.

Question 41

Are crucial because they mediate the effects of serotonin, a key neurotransmitter involved in regulating mood, anxiety, sleep, appetite, and other physiological processes.

Answer 41

5-HT Receptors (serotonin receptors)

Question 42

What are examples of medications targeting GABA-A Receptors?

Answer 42

Benzodiazepines: Examples: Diazepam (Valium), Clonazepam (Klonopin). Uses: Short-term treatment of anxiety disorders. Z-Type Hypnotics: Examples: Zopiclone, Zolpidem (Ambien). Uses: Short-term treatment of sleep impairment (insomnia). Sodium Valproate: Uses: Mood stabilizer for conditions like bipolar disorder.

Question 43

Medications that target the GABA-A receptor, such as benzodiazepines and Z-type hypnotics which have a calming effect on the brain and body

Answer 43

Downers

Question 44

What can second messenger systems do?

Answer 44

They can enhance the release of neurotransmitters. They can also influence other cellular processes, such as gene expression and enzyme activity. They help coordinate various cellular processes. They ensure the cell responds appropriately to external signals (neurotransmitters).

Question 45

The concentration of a drug in the blood plasma, which is the liquid component of blood.

Answer 45

Plasma Levels

Question 45

A type of receptor that activates second messenger systems when bound by a neurotransmitter.

Answer 45

G-Protein Coupled Receptor

Question 46

Why are plasma levels important?

Answer 46

Therapeutic Range: For a drug to be effective, its plasma levels need to be within a specific range. Monitoring: Doctors monitor plasma levels to ensure the drug is working effectively and to avoid toxicity.