Flashcards in Antidepressants and Mood Stabilizers Deck (16):
Describe two policies that have reduced suicide by limiting means.
- In England, the most common method of suicide until the 1970s was using the oven. After the country switched to clean gas that cannot be used as a lethal tool, suicide rates dropped by 30%
- In Israel, there had been a high suicide rate among those in the military. Most suicides were on the weekend, so the military prohibited taking guns home over the weekend; this lowered the suicide rate.
The time course of ________________ corresponds to response to treatment.
brain-derived neurotrophic factor (BDNF)
Placebo studies have shown what effect in the use of SSRIs?
That placebos have a similar response immediately, but that relapse rates are higher in groups on placebos
The STAR-D (sp?) study demonstrated what?
That people need to be on antidepressants for 8 - 14 weeks to evaluate efficacy
Bupropion is contraindicated in what patients?
Those with bulimia; it can induce seizures in anyone, but it is especially so in those with bulimia.
All antidepressants have shown ______________, but ________________.
efficacy in treating depressing; there are no trials comparing efficacy between newer drugs
What are the pros and cons of tricyclic antidepressants?
- time-tested efficacy
- more effective in severe depression
- blood levels can be monitored
- alpha blocking leads to orthostatic hypotension
- antimuscarinic effects
- sexual side effects
What drug combination led to Libby Zion's death?
MAO inhibitor and demerol (a pyridine that requires MAO to be metabolized)
What are the side effects of SNRIs?
Withdrawal leads to flu-like symptoms and "electric shock" symptoms in the back of the head
What are the three approved treatments for bipolar depression?
Olanzapine + fluoxetine
There are zero "large" trials showing positive results in treating bipolar depression.
True or false: valproic acid is used as a maintenance treatment.
False. It is only used as an acute treatment for mania.
It's thought that SSRIs may promote the expression of _______________, leading to increased neuronal growth (specifically in the hippocampus).
True or false: more than 50% of people treated with SSRIs will achieve complete remission.
False. Only about 1/3 will.
What is the mechanism of mirtazapine?
It blocks 5HT2A, 5HT2C, 5HT3, and alpha-2.
Mirtazapine is also helpful in treating _____________.