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3 Psychiatry > Pharmacology of Antidepressants and Mood Stabilisers > Flashcards

Pharmacology of Antidepressants and Mood Stabilisers Flashcards

1
Q

antidepressants are used for depression of what severity?

A

moderate to severe

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2
Q

antidepressants are used for what other clinical conditions aside from depression?

A 
anxiety
dysthymia
panic disorders - OCD/PTSD
bulimia nervosa
neuropathic pain
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3
Q

main MoA of antidepressants? how do they do this?

A

increase levels of monoamines in the body by:
inhibiting monoamine oxidase OR
inhibiting monoamine/serotonin reuptake into the cell (more for the body)

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4
Q

what are the neurotransmitters for monamine?

A

noradrenaline
5-HT
dopamine

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5
Q

if your monoamine levels drop, your mood goes __

A

down

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6
Q

what particular chemicals do people lack in depression?

A

serotonin (5-HT)

NA

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7
Q

name the 2 main serotonin systems

A

rostral

caudal raphe

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8
Q

what areas of the brain does the rostral pathway cover?

A

limbic
subcortical
cerebral cortex

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9
Q

name the 2 noradrenaline projection pathways?

A

lateral tegmental area

locus coeruleus

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10
Q

which noradrenaline pathway covers msot of the brain?

A

locus choeruleus

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11
Q

the rostral serotonin pathway is responsible for what functions?

A

mood
sleep
feeding behaviour
sensory perception

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12
Q

the locus coeruleus is responsible for what function

A

arousal

emotion

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13
Q

how do MAO inhibitors work

A

conc of moonoamines goes up presynaptically as less is taken up

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14
Q

give an example of MAO inhibitors?

A

phenelzine

moclobemide

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15
Q

which MAO inhibitors are irreversible in action?

A

phenelzine

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16
Q

what food should be avoided in MAO inhibitors and why?

A

“cheese reaction” - MAO prevents breakdown of dietary tyramine = increased BP + headaches

other yeast products eg gravy/wines

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17
Q

side effects of MAO inhibitors?

A

hypertensive crisis - cheese and tyramine
postural hypotension
insomnia
peripheral oedema

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18
Q

MoA of tricyclics?

A

block reuptake of MAO (less serotonin and NA removed)

19
Q

give examples of tricyclics?

A

amitryptiline
imipramine
dosulepin
lofepramine

20
Q

side effects of tricyclics?

A 
anti-cholinergic effects
sedation
weight gain
postural HT, tachy, arrhythmia
constipation
21
Q

what are anti-cholinergic effects

A

blurred vision
dry mouth
urinary retention

22
Q

name anti-histaminergic side effects

A

sedation

weight gain

23
Q

what kind of drug is fluoxetine?

A

SSRI

24
Q

give examples of SSRIs

A

fluoxetine

citalopram

25
Q

SSRIs inhibit serotin reuptake at…

A

the synaptic cleft

26
Q

side effects of SSRIs?

A 
nausea
headache
sweating/vivid dreams
anxiety worse
sexual dysfunction
increased self harm if young
27
Q

main electrolyte disturbance from SSRIs?

A

hyponatraemia

28
Q

how can SSRIs make you sick?

A

too much serotonin (5-HT3) in the body can cause nausea

29
Q

duloxetine is an example of…

A

SNRI (serotonin noradrenaline reuptake inhibitor)

30
Q

too much 5-HT2 can cause….

A

headaches

31
Q

what does mirtazapine block?

A

alpha 2 receptors
5HT2
5HT3

32
Q

side effects of mirtazapine?

A

histaminergic side effects eg weight gain and sedation

33
Q

antidepressants can be combined safely T or F

A

F, tend to make side effects worse

34
Q

1st and 2nd line antidepressants

A

1.SSRI

2, another SSRI

35
Q

lithium is given for what disorder and as what compound?

A

BPAD

lithium carbonate

36
Q

gold standard Tx for bipolar disorder?

A

lithium carbonate 400mg

37
Q

main problem with lithium as a drug?

A

narrow therapeutic index

38
Q

common side effects of lithium?

A 
ITS A SALT:
dry mouth/strange taste?
polydipsia/polyuria
tremor
reduced renal function
nephrogenic DI
weight gain
39
Q

lithium can cause what thyroid problem?

A

hypothyroidism

40
Q

someone who has lithium poisoning will present with…

A 
vomiting
diarrhoea
ataxia/coarse tremor
drowsiness
convulsions
coma
41
Q

what teratogenic defects does valproate cause?

A

neural tube defects

42
Q

examples of anti-psychotics?

A

quetiapine
aripiprazole
olanzapine
lurasidone

43
Q

what SSRI is really bad for withdrawal if removed immediately?

A

paroxetine

44
Q

antidepressants with a ___ effect tend to cause weight gain

A

sedative (eg tricyclics)

3 Psychiatry (28 decks)

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