Antidepressants

Question 1

Iproniazid

Answer 1

~ block reuptake of both serotonin and noradrenaline

~ tricyclic antidepressant

Question 2

Name the side effects of Imipramine.

Answer 2

~ dry mouth
~ impaired muscular control in eye (blurred vision)
~ tachycardia
~ constipation
~ weight gain

Question 3

Monoamine hypothesis

Answer 3

depression is caused by a deficiency of monoamine NT e.g. noradrenaline + serotonin

Question 4

Name the evidence for the monoamine hypothesis.

Answer 4

1. drugs that reduce monoamine NT = depression

2. known antidepressants increase monoamine NT = alleviate depression

Question 5

Name the two discoveries that lead to the monoamine hypothesis.

Answer 5

(Ashcroft + Eccleston, 1960) - decreases serotonin and 5HT were found in brain autopsies of sucide victims
(Axelrod, 1961) - monoamine reuktake blocked by imipramine

Question 6

Serotonin + depression

Answer 6

serotonin transmission in raphe nuclei is decreased in depressed patients

Question 7

Problems with monoamine hypothesis 1.

Answer 7

~ Time lag between administration of drug and relief of depressive symptoms
~ antidepressants boost NA and 5HT levels immediately

Question 8

Problems with monoamine hypothesis 2.

Answer 8

~ Inconsistent findings regarding decreased NA and serotonin in depressed patients
~ maybe changes in NT receptors sensitivity mediate the clinical effects of antidepressant drugs (new theory, needs further investigation)

Question 9

SSRIs

Answer 9

a.k.a. Selective Serotonin Reuptake Inhibitors e.g. Prozac
~ increase serotonergic activity
~ drugs are 1st choice for treating depression as they produce less severe side effects

Question 10

Side effects of SSRIs.

Answer 10

~ mild nausea

~ sexual dysfunction (symptoms decrease as treatment progress)

Question 11

Symptoms of depression.

Answer 11

~ cognitive (feelings of low self-worth + guilt)
~ physical (loss of appetite + insomnia)
~ emotional (persistently sad, anxious + hopelessness)
~ motivational (lack of motivation + aspiration)

Question 12

Iproniazid

Answer 12

~ 1st antidepressant
~ monoamine agonist
~ increases lvls of serotonin, noradrenaline and dopamine by inhibiting monoaminooxidase (MAO)

Question 13

Name the side effects of Iproniazid.

Answer 13

~ liver damage

~ disfunction in blood pressure control –> hypertensive crisis

Question 14

How can Iproniazid cause a hypertensive crisis?

Answer 14

~ it is a non-specific MAO blocker

~ blocks MAO-A which when inhibited takes only 10mg of tyramine to cause increased blood pressure

Question 15

Tyramine

Answer 15

amino acid found in mature cheese, red wine and marmite

Question 16

SSRI vs SNRI

Answer 16

~ study in healthy volunteers showed there was a right and wrong drug for people
~ compared effects of sertraline (SSRI) and reboxetine (SNRI)
~ some people did well on one and not on the other

Question 17

Sertraline

Answer 17

~ SSRI

~ causes emotional blunting

Question 18

Antidepressants + age

Answer 18

~ they stop working as well when you get to 65yr+ so augmenting strategies are used
~ common problem in Major Depressive Disorder

Question 19

SNRIs

Answer 19

A.k.a. serotonin-noradrenaline reuptake inhibitors

~ work similarly to SSRIs

Question 20

Iproniazid

Answer 20

~ MAOI

~ 1st antidepressant made, accidentally as meant to treat TB

Question 21

MAOIs

Answer 21

black the enzyme monoamine oxidase by irreversibly inhabiting it

Question 22

MAO

Answer 22

family of enzymes that metabolise + inactivate monoamine NT

Question 23

Reboxetine

Answer 23

~ SNRI

~ creates energised feelings

Question 24

Treatment-resistant depression

Answer 24

when normal anti-depressants don’t work, solution is to try combination of SSRIs + other drugs
e.g. symbyax = prozac + zyprexa