Antidepressant Drugs

Question 1

Affective Disorders

Answer 1

Group of mental conditions that includes depression and bipolar disorder
Characterized by changes in mood
Distinct from schizophrenia (produces disturbances of thought)
Most prevalent mental illness in US/Canada
Can be exacerbated or triggered by stressful incident, or be idiopathic onset
Role of genetic factors in unclear - higher incidence of depression in offspring of parent(s) with depression

Question 2

4 Goals of Pharmacology for Depression

Answer 2

Relieve symptoms of depression
Prevent suicide
Restore optimal functioning
Prevent recurrence

Question 3

What 3 NTs does Monoamine Oxidase Inhibit?

Answer 3

1. Norepinephrine
2. 5-hydroxytryptamine (Serotonin)
3. Dopamine

Question 4

MAO

Answer 4

Monoamine Oxidase
A mitochondrial enzyme
Found in neural and other tissues
Inactivates excess catecholamines in nerve ending

Question 5

MAO Inhibitor Adverse Effects (3)

Answer 5

1. Hypertensive crisis can result due to increased stores of NOR
2. Tyramine levels can increase (have to be really careful of what they eat)
3. Risk of serotonin syndrome (while you’re switching to a new drug - get seizures, hypothermia, etc)

Question 6

Tricyclic and heterocyclic Antidepressants Adverse Effects (4)

Answer 6

1. Excessive sedation
2. Antimuscarinic effects
3. Sympathomimetic effects
4. Orthostatic hypotension, EEG abnormalities

Question 7

Antimuscarinic effects

Answer 7

Side effect of Tricyclic and Heterocyclic ADs
Blocks muscarinic, alpha 1, and adrenergic receptors in periphery
Blocking alpha 1 gives you orthostatic hypotension
Can also get cardio abnormalities and arrhythmias

Question 8

SSRI adverse effects

Answer 8

1. Nausea
2. Headache
3. Anxiety/Agitation
4. Insomnia
5. Sexual dysfunction

May also precipitate suicidal ideologies and suicidal feelings in young adolescents

Question 9

Mirtazapine

Answer 9

Has antidepressant and antianxiety properties

Blocks presynaptic apha2-AR and increased NE and 5-HT release

Question 10

Bupropion

Answer 10

Weak inhibitor of DA, 5-HT, NE uptake
Few side effects (no sedation, decreased CV effects, and no sexual dysfunction)
Used for patients who want to quit smoking

Question 11

2 theories of depression

Answer 11

1. Monoamine theory

2. Neurotropic Hypothesis (increased BDNF transcription and increased synaptogenesis in chronic use)

Question 12

4 goals for antidepressant drugs

Answer 12

Relieve symptoms of depression
Prevent suicide
Restore optimal functioning
Prevent recurrence