Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drugs and Behavior > Exam 4: Treatment for Affective Disorders > Flashcards

Exam 4: Treatment for Affective Disorders Flashcards

(54 cards)

Start Studying
1
Q

reserpine

A

reduces high blood pressure
induces depression as a side effect
prevents packaging of neurotransmitters into vesicles, leaves in synapse whereMAO can degrade them

it reduces levels of DA, NE and 5-HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

serotonin and depression

A

significant influence on sensitivity to pain, emotionality, response to negative consequences or reward

  • having low levels of serotonin does NOT cause depression, except in vulnerable individuals
  • tryptophan challenge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

tryptophan challenge

A

tryptophan is what gets converted into serotonin

if give drink that dec tryptophan in ppl with a history of depression it will cause depression symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

5-HIAA levels

A

the serotonin metabolite
low levels of 5-HIAA found in postmortem brains of depressed individuals
-low levels associated with 5 fold inc in suicide risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MDD patients have low levels of what in cerebral spinal fluid (spinal tap)

A

5-HT, TPH, 5-HIAA

lowered serotonin is problem in people with depression but does not mean the person will become depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

brains of unmedicated individuals with mood disorders have inc what

A

inc density of postsynaptic 5-HT2 receptors (with hallucinogens too)
this is compensatory response to low serotonergic activity
-more receptors to try to recapture as much serotonin as possible
-antidepressants reduce 5-HT2A receptor binding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

examples of tricyclic antidepressants

A

amitriptyline, chlorimipramine, imipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is NE involved in

A

neuroendocrine function, reward, attention and arousal, response to stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

NE and depression

A

dowwn regulation of B-receptors with chronic antidepressant treatment
-takes 7-21 days of treatment to see effects - delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

types of antidepressant drugs

A

MAOIs, TCA, second generation antidepressants(SSRIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

nondrug therapies

A 
sleep deprivation
electroconvulsive therapy (shock)
transcranial magnetic stimulation
vagal nerve stimulation
deep brain stimulation

exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

dopamine

A

involved in motivational deficits associated with depression

anhedonia (loss of pleasure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

does anxiety or depression come first

A

anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

anxiety vs depression neurochemistry

A

anxiety = too much serotonin, NE, DA

depression= not enough serotonin, NE< DA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

anxiety increases SERT…more SERT =

A

less serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ROA of antidepressants

A

typically oral
transdermal gel or patch - longer lasting actions
- ex: selegiline: MAOI with transdermal patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Absorption of antidepressants

A

max blood concentrations:

  • TCA: 1-2hrs
  • MAOIs: 2-3hrs
  • SSRIs/SNRIs: 4-8hrs

1st pass metabolism dec bioavailability - oral drugs
-inhibited by alcohol - slows breakdown of drugs

depot binding!!!
-SSRI Fluoxetine has over 95% depot binding - longer time of peak levels in blood, longer half life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

distribution of antidepressants

A

most cross BBB and placental barrier
concentrate in lungs, liver, kidneys, brain

lipid soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

metabolism of antidepressants

A

inhibition of MAO in liver (normally MAO breaks down dietary tyramine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

dietary tyramine

A

formed as byproduct of fermentation in cheeses, meats, pickled products, other foods
people on MAOIs given list of foods they should avoid bc they can cause a dangerous spike in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does elevated tyramine do

A

releases higher than normal stores of NE at nerve endings, causing dangerous increases in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MAOIs inhibit CYP450s

Study These Flashcards
A

effects of alcohol, barbiturates, opiates, aspirin all intensified in presence of MAOIs (enzyme inhibition)
competition for enzymes!

23
Q

side effects of MAOIs

Study These Flashcards
A

changes in BP
sleep disturbances - interesting bc sleep disturbances is problem with depression and this is going to cause it
overeating/weight gain

24
Q

how do most antidepressants increase 5-HT

Study These Flashcards
A

blocking reuptake or inhibiting MAO

-prevent 5-HT breakdown or prevent it from being repackaged

25
acute effects of increased serotonin
gives cell more opportunity to activate the 5-HT1A autoreceptor to slow cell firing and reduce synaptic serotonin
26
chronic serotonin treatment results in
down regulation of 5-HT1A sutoreceptors and synaptic 5-HT increases this inc is just initial step, other changes required like hippocampal neurogenesis and functional remodeling of corticolimbic circuits
27
MAOIs increase amount of...
serotonin, NE, DA available
28
action of TCAs
bind to presynaptic transporter proteins and inhibit reuptake of neurotransmitters - prolongs duration of transmitter action at synapse diff TCAs have diff NE and 5-HT reuptake blocking potencies inc in synaptic activity first step but NEED neuronal adaptation
29
side effects of TCAs
also block histamine, acetylcholine, and a1 receptors
30
anticholinergic effects of TCAs
``` dry mouth constipation urine retention dizziness confusion impaired memory blurred vision ```
31
a1 receptor blockade of TCAs
coupled with NE reuptake blocking leads orthostatic hypotension, tachycardia, arrhythmias - overdose causes cardiovascular depression, delirium, convulsions, respiratroy depression, coma - heart arrythmias can produce ardia arrest
32
histamine receptor blockade - TCAs
causes sedation and fatigue that limit the drugs usefulness - positive effect for people with sleep dysfunction for patients with agitation these side effects help
33
do TCAs have a high or low therapeutic index
low! - fatalities occur at approximately 10 times the normal dose - can also get overdoses if take TCAs with alcohol
34
SSRIs
block 5-HT reuptake transporters more than NE transpoters | -used to treat panic and anxiety disorders, OCD, obesity, alcohol use disorder
35
serotonin syndrome
SSRIs have potentially life-threatening effects when combines with other serotonergic agonists or drugs that interfere with metabolism of the SSRIs
36
mild symptoms serotonin syndrome | how to manage
mydriasis shivering sweating tachycardia manage: observe for at least 6 hrs and BENZOS
37
moderate symptoms of serotonin syndrome | how to manage
altered mental status (agitation, disorientation) rigidity, tachycardia, hyperthermia tremor, hypereflexes manage: hospital cardiac monitoring, cyproheptadine
38
life threatening symptoms of serotonin syndrome | how to manage
delirium, hypertension, hyperthermia, muscle rigidity, tachycardia manage: ICU, esmolol or nitroprusside, cooling measures, ventilation, SkM paralysis, sedation
39
is it more beneficial to enhance both NE and 5-HT function or just one
both
40
mirtazapine
antagonist for a2 autoreceptors inc synaptic NE and a2 heteroreceptors on serotonergic cells inc 5-HT release also antagonist for 5-HT2 receptors
41
what is the most effective medication for patients with bipolar disorder
lithium carbonate - flattens extremes of emotion - has no effect on healthy ppl but reduces manic episodes without causing depression or producing sedation - effective in dec suicides in bipolar
42
lithium ROA
oral
43
absorption and distribution of lithium
readily absorbed by GI tract peak plasma conc 30min-3hr brain peak conc 18-24 hrs no depot binding, no 1st pass metabolism
44
metabolism and excretion of lithium
NO metabolism 100% excreted unchanged in urine half life: 18-30 hrs
45
side effects of lithium
low therapeutic index blood levels of lithium must be monitored regularly mild but can include inc thirst and rination, impaired conc and memory, fatigue, tremor, weight gain
46
lithium pharmacodynamics
many system - 5-HT, DA, GABA, glutamate 2nd messenger systems lithium downregulates NMDA and DA receptors (dec Ca ion influx through NMDA receptors) lithium enhances 5-HT actions (elevates brain tryptophan, 5-HT, 5-HIAA and inc 5-HT release lithium inc GABA levels and inc GABA B receptors
47
what does lithium downregulate
NMDA and DA receptors | reduces Ca ion influx
48
treatment for bipolar disorder
anticonvulsant drugs | -valproate and carbamazepine
49
valproate (depakote)
bipolar anticonvulsant treatment - inc GABA levels in brain - dec glutamate in brain
50
carbamazepine (tegretol)
anticonvulsant for bipolar resembles TCAs and inhibits NE reuptake -blocks adenosine receptors in sleep
51
addiction and withdrawal
no euphoria little to no abuse liability for SSRIs, TCAs, MAOIs but can cause physical dependence
52
physical dependence and antidepressants
-sudden discontinuation of high dose TCAs - restlessness, anxiety, chills muscle aches, akathisia
53
SSRI withdrawal
dizziness, insomnia, fatigue, anxiety, nausea
54
withdrawal from NE targeting drugs
heart palpitations, psychiatric symptoms - delusions

Drugs and Behavior (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions