Anxiety and depression

Question 1

Name some common anxiety disorders

Answer 1

generalised anxiety disorder
post traumatic stress disorder
phobias
obsessive compulsive disorder OCD

Question 2

Describe the symptoms of anxiety

Answer 2

palpitations, tachycardia, SOB, dizzieness, sweating, tremor, panic

Question 3

name some non pharmalogical treatments of anxiety

Answer 3

CBT, meditation, mindfullness, relaxation techniques

Question 4

Which main 2 pharmacological approach is used to treat anxiety

Answer 4

beta blockers - propanol

benzodiazepine

Question 5

what must you be careful of if you take this regularly

Answer 5

stopping immediately - has a rebound effect

Question 6

Name 7 effects of valium

Answer 6

sedative
anticonvulsive 
hypnotic 
muscle relaxant 
decreases aggresion 
anxiolytic 
amnesic

Question 7

Valium

1. DWT?
2. SEs?
3. be careful when prescribing to ?
4. two other positives

Answer 7

1. dependance, withdrawal, tolerance, therefor abuse potential
2. can cause aggression rarely (paradoxical seizures)
3. elderly people
4. safe in overdose and doesnt have any drug interactions

Question 8

What would you prescribe benzodiazepine with a short half life for and one with a long half life for

Answer 8

short - hypnotics

long - anti anxiety

Question 9

How do benzodiazepines work?

Answer 9

increase GABA receptor affinity for Cl- hyperpolerisation of neurones

Question 10

1. Two more drugs that can be used to treat anxiety?

2. -ve to using one of them

Answer 10

buspirone and SSRis

takes a long time to work

Question 11

What must you have to diagnose depression

Answer 11

Must include 
1. depressed mood
2. loss of interest 
and 3 from.. 
weight change, altered sleep, agitation, fatigue, suicidal thoughts, worthless feeling, cant concentrate

Question 12

how do you treat bipolar + mechanism

Answer 12

lithium salts - inhib Glycogen synthase kinase 3

Question 13

genetics vs environment in depression?

Answer 13

sever depression mostly genetics

mild depression mostly environment

Question 14

Describe the 3 theries of depression

Answer 14

1. amine dysfunction - reduced NA/5ht (or receptor down reg)
   althered dopamine function - reward pathways?
2. HPA axis dysfunction - to much cortisol
3. neurotropic and neuroplasticity hypothesis - physical changes in cortical areas

Question 15

What evidence leads us to believe HPA theory of depression

Answer 15

insensitivity to DEX (usually suppresses cortisol)

Question 16

Name 3 non pharamological treatments to depression

Answer 16

CBT, Electroconvulsive shock treatment , St johns wort

Question 17

TCAs - mechanisms

Answer 17

block amine reuptake
H2 antag (sedative SE)
M antag (CV SE)
block amine reuptake peripheraly (CV SE)

Question 18

what are ipronizid, phenelzine, tranylcypromine, moclobemide?

Answer 18

MAOi’s

Question 19

Problems with MAOis

Answer 19

initial euphoria, slow onset, some Muscarinic SE, insomnia, weight gain and liver damage

Question 20

What interaction must you be careful of if taking a MAOi

Answer 20

cheese reaction - tyramine is usually broken down by MAO - if not can get into head and cause increased dopamine = hypertension

Question 21

Side effects to SSRIs

Answer 21

neausea, loss of libido, akathisia (restless) agitation

Question 22

what does akathisia mean

Answer 22

restless

Question 23

Why do all antidepressants take so long to work

Answer 23

10/20 days. autoreceptors turn down the amount of amines released - decrease APs and block further release of NT

Question 24

SSRI SNRI NaSSA NARI mean?

Answer 24

selective seritonin reuptake inhibitor
seratonin and noradrenaline reuptake inhibitor
Noradrenergic and specific serotinergic
noradrenaline reuptake inhibitor

Question 25

Benefits of using a selective

1. 5HT2 antag
2. 5HT1 antag

Answer 25

1. less sexual side effects

2. less nausea