5.0 Antidepressants

Question 1

What are the clinical features of depression?

Answer 1

• Physiological
• Psychological
• Cognitive

Question 2

What are the sxs under the physiological feature of depression?

Answer 2

• Decreased sleep
• Appetite changes
• Fatigue
• Psychomotor dysfunctions
• Other: menstrual irregularities, palpitations, constipation, headaches, nonspecific body aches

Question 3

What are the sxs under the psychological feature of depression?

Answer 3

• Dysphoric mood
• Worthlessness
• Excessive guilt
• Loss of interest/pleasure in all or most activities

Question 4

What are the sxs under the cognitive feature of depression?

Answer 4

• Decreased concentration
• Suicidal ideation

Question 5

What antihypertensive and CV drugs can cause depression?

Answer 5

• Reserpine
• Methyldopa
• Propranolol
• Metoprolol
• Prazosin
• Clonidine
• Digitalis

Question 6

What sedative-hypnotics drugs can cause depression?

Answer 6

• Alcohol
• Benzos
• Barbiturates
• Meprobamate

Question 7

What anti-inflammatory and analgesic drugs can cause depression?

Answer 7

• Indomethacin
• Phenylbutazone
• Opiates
• Pentazocine

Question 8

What steroid drugs can cause depression?

Answer 8

• Corticosteroids
• Oral contraceptives
• Estrogen withdrawal

Question 9

What other drugs can cause depression?

Answer 9

Drugs for:
- Anti-parkinson
- Anti-neoplastic
- Neuroleptics

Question 10

What does the “biogenic amine” hypothesis of depression consist of?

Answer 10

• Reserpine causes depression by depleting NE and 5HT from vesicles
• Agents that increase 5HT and NE are effective for tx depression
• Genetic polymorphisms in SERT promoter
• Alterations in 5HT1A/2C and alpha2 receptors

Question 11

What does the neuroendocrine hypothesis of depression consist of?

Answer 11

• Overactivity of HPA and elevated CRF found in almost all depressed pts
• Overactivity of HPA may desensitize feedback response in hypothalamus and pituitary
• Elevated CRF causes insomnia, anxiety, and decreased appetite and libido
• Antidepressants and ECT reduce CRF levels

Question 12

What functions is the CRF1 receptor responsible for?

Answer 12

• Arousal
• Anxiety-like behavior
• Disruption of sexual behaviors
• Disruption of sleep

Question 13

What functions is the CRF2 receptor responsible for?

Answer 13

• Slow adaptive recovery
• Appetite suppression

Question 14

What function is the CRF3 receptor responsible for?

Answer 14

Activation of the HPA axis