Flashcards in Anti-depressant agents Deck (16):
ANtidepressive pathways involve monoamines how?
NE and 5HT acts on GPCR and brain derived neurotropic factors (BDNF) acting on TrkB to switch on genes that promote neurogenesis and protecting against apoptosis.
5HT reuptake inhibitors
(no sedative and no antimuscarinic action)
can cause hypertensive crisis with decongestants or foods high in tyramine due to acute increase in NE release
(presynaptic accumulation and release into synapse)
How many days does it take for onset of therapeutic effect of Lithium?
10-21 days for onset
How does lithium work as an antimanic drug?
Increase 5HT action or diminish NE + DA effect by interference with PIP recycling
DOes Lithium have a high or narrow therapeutic index?
(BDZ have high)
- good for both manic and depressive episodes, common in combo with other agents
____ disorders are the most common psychiatric illnesses, followed by ___ disorders
Anxiety, mood (25%)
SIGECAPS is when how many symptoms have persisted for _____ weeks
E for at least 1 week, and present most of the day nearly every day
mood worse in the morning early morning awakenings, anorexia, weight loss, guilt
Bipolar I vs Bipolar II
I: pts with only mania
II: pts with hypomania AND major depression
Mood disorder diff dx
Mood disorders (bipolar + depressive disorders) can be due to :
- cushings, hyper/hypothyroidism, steroids
- HIV, influenza, mengitis, Creutzfeld Jakob
- Stroke, tumor, MS, epilepsy
Depressive disorder types
Major depressive disorder
True/False depression is a chemical imbalance as well as defect in multiple interactive pathways
- not chemical imbalance
- yes to neuroendocrine dysfxn
Neuroendocrine dysfxn in depression
Activation of HPA axis to stress →
paraventricular nucleus of hypothalamus secretes CRF →
anterior pituitary secretes (ACTH) →
adrenal cortex secretes cortisol/glucocorticoids →
affects general metabolism/behavior