Drugs For Mood Disorders

Question 1

Depression definition

Answer 1

Sad,despondent mood

Question 2

Types of Depression

Answer 2

Major depressive disorder (MDD)
Situational 
Dysthymia or persistant depressive dis.
Postpartum depression (PPD)
Premenstrual dysphoric disorder (PDD)
Seasonal affective disorder (SAD)
Psychotic

Question 3

Non-drug approaches(depression)

Answer 3

• Cognitive behavioral therapy
• Electroconvulsive therapy (ECT)
• Repetitive transcranial magnetic stimulation (rTMS)

Question 4

Neurotransmitters to Depr./Strategy

Answer 4

Block breakdown of NE/ uptake of 5HT

SSRI- block 5HT reuptake
SNRI- block 5HT and NE reuptake
TCA- block 5HT and NE reuptake
MAOI- block NE/DA degradation

*all are efficacious

Question 5

Neurotransmitter Safety

Answer 5

SSRI>SNRI>TCA>MAOI

Question 6

SSRI Drugs/MoA

Answer 6

Citalopram (Celexa)
Escitalopram(lexapro)
Fluoxetine (prozac)
Paroxetine(paxil)
Setraline(zoloft)

Antagonize SERT to block reuptake of 5HT

Side effects: most common is sexual dysfunction

Question 7

Atypicals (incl. SNRIs) Drugs

Answer 7

Duloxetine(cymbalta)
Venlafaxine(effexor)
Trazodone(oleptro, desyrel)
Bupropion (wellbutin)
Vortioxetine (brintellix)

Question 8

Duloxetine(cymbalta) moa

Answer 8

5HT and NE reuptake inhibitor/SNRI

(-) NET and SERT

Question 9

Venlafaxine(effexor) moa

Answer 9

5HT and NE reuptake inhibitor/SNRI

(-) NET and SERT

Question 10

Trazodone(oleptro, desyrel) moa

Answer 10

(-)5HT2 -counterintuitive

(-)alpha 1 adrenergic receptorsi

Question 11

Bupropion (wellbutin) moa

Answer 11

(-) NET amd DAT / may stimulate NE and DA release

Side effects:
alpha 1 antagonism-hypotension
Dysrhythmias

Question 12

Vortioxetine (brintellix) moa

Answer 12

Complex moa

(-)SERT
Partial agonist of 5HT 1a/1b
(-) 5HT 1d, 3, 7

Some ppl have mutation in SERT and antidepressants do not work for them

Question 13

Tricyclics drug/ moa

Answer 13

Amitriptyline (elavil)

(-) NET and SERT

Side effects:
H1 receptor antagonist- drowsiness
Anticholinergic effects
“Dirty drug”

Question 14

MAOI drugs/moa

Answer 14

Phenelzine( nardil)

Inhibit MAO-inhibit metabolism of NE, Epi, and dopamine

Inhibit breakdown of tyramine which can lead to hypertensive crisis bc mimics NE

Question 15

Bipolar Disorder

Answer 15

Alternating episodes of mania and depression

Bipolar 1- one manic episode
Bipolar 2- one major depressive + one hypomanic episode
Cyclothia-low level depressive and hypomania

Question 16

Mood Stabilizers (Bipolar) drugs

Answer 16

Lithium (eskalith)

Question 17

Lithium (eskalith) moa

Answer 17

Modulates celluar metabolism and signal transduction-> suppresses neuronal activity

Narrow Ti and side effects include weight gain or tremors

*first line tx for bipolar 1

Question 18

Atypical Antipsychotics (Bipolar) Drugs

Answer 18

Aripriprazole (abilify)

Risperdone (risperdol)

Question 19

Aripriprazole (abilify) moa

Answer 19

Dopamine D2 receptor antagonism

-5HT 2a weak partial (+)

Question 20

Risperdone (risperdol) moa

Answer 20

(-) D2 receptors and (-) 5HT2a receptors

Question 21

Antiseizure (Bipolar) drugs/moa

Answer 21

Carbamazepine (tegretol)-na+ desens

Lamotrigine (lamictal) na+ desens

Valporic acid (depakene, depakote) na+ channel desens and (+) GABA / (-) Ca+ channel

Question 22

ADHD

Answer 22

Hyperactive and Attention defec.

Question 23

Stimulants (ADHD)

Answer 23

• mainly CNS stimulants

Methylphenidate (ritalin, concerta)
Amphetamine (adderall)
Methamphetamine (desoxyn)

Question 24

Methylphenidate (ritalin, concerta) moa

Answer 24

Blocks DA, 5HT, NE reuptake

Schedule 2

Question 25

Amphetamine (adderall) moa

Answer 25

Inc DA, 5HT and NE neurotransmission

Question 26

Methamphetamine (desoxyn) moa

Answer 26

Enhances release of DA, 5HT, and NE

Question 27

Non-Stimulant (ADHD) drug/moa

Answer 27

Atomoxotine (stratterta)

Selectively inhibits NE reuptake in prefrontal cortex-> calming effect