ANXIETY AND DEPRESSION Flashcards
(24 cards)
What is anxiety?
Normal physiological response to stress - avoidance, increased vilgilance, prepare for fight or flight
Feelings of fearfulness, apprehension, terror. Sweating trembling, increased heart rate, heart pounding,
Whats the anxiety disorders?
Intensity of feelings out of proportion to the danger
- chronic - general anxiety
- acute - panic attack
Recurrent intrusive thoughts or impulse
How does anxiety become abnormal?
Excessive anxiety leading to atypical, maladaptive, irrational behaviour and personal distress
Generalised anxiety disorder
- panic disorder
- phobias
- agoraphobia
At any given time 20% of the adult population suffer from an anxiety disorder
Whats the stress response?
Cascade of hormonal events, release of
corticotrophin releasing factor (CRF) –
corticotrophin release – release of stress
hormones (glucocorticoids and adrenaline)
from the adrenal cortex
• Activated when survival is threatened
• By an actual threat
• By anticipation of a threat
• Glucocorticoids also exert negative feedback,
decreasing release of CRF
Describe the flow for anxiety
Homeostatic response to the stressor → physiological adaptations → return to set point
➢Anxiety is a normal homeostatic response
Models of anxiety?
Evaluated plus maze - where two arms have no walls and two have operate walls
- rodents spend less time in the open a rms than the closed ones
Anxiogenic effect seen by spending less time in open arms
Anxiolytic effect seen by spending more time in open arms
Model of anxiety - open field?
A large, brightly lit areana
- rodents prefer not to sped time in the middle of the arena
Anxiogenic effect - spend even less time in the middle of the arena
Anxiolytic effect - spend more time in the middle of the arena
What does stress response activate?
Hypothalamus - pituitary - adrenal system
What type of response is anxiety?
Homeostatic response to a stressor leading to physiological adaptions to return the system to a set point
Whats the oldest known anxiolytic drug for reducing anxiety?
Alcohol
- sedatives
- not very high effective and short duration of action
- risk of depdence and rebound effects
Whats benzodiazepines?
Introduced in mid 1950s
Profound sedative, muscle relaxant
- therapeutic index was extremely high
- much reduced abuse potential
Treatments for depression?
Pre 1950s
Main treatment was electroconvulsive therapy (ECT) or, in extreme cases,
brain surgery or insulin shock
• ECT may still be used for suicidal patients
No drug treatments were available
1950s - First pharmacological treatment - Iproniazid
• Used as an antibiotic (for tuberculosis)
• Reported to elevate mood
• Kline (1956) : iproniazid reduced depression in several patient groups
• Marketed as the first antidepressant drug
• Known to be a monoamine oxidase inhibitor (MAOI
What does tyrosine synthesis
Dopamine and noradrenaline
Increasing GABA function..?
Reduces anxiety
-may be beenfiacal for anxiety disorders by breaking the anxiety cycle
What’s reserpine?
Extracted from Indian snake root plants
- used as a tranquiliser and for treating high blood presssure
- found to produce severe, often suicidal, depression
1960s - found that reserpine depletes monoamines in the brain - no adrenaline, dopamine and serotonin
Prevents their storage in the terminal prior to release
What shildkraut find?
Brought several Pharamacological findings together
Serotonin (5HT) and no adrenaline thought to be particularly important
Symptoms of depression?
Increase perisit sadness, feelings of helplessness, worthlessness, loss of intrest.
Whats the monoamine theory?
Symptoms due to a lowering of function of monoamine transmitters, mainly serotonin and noradrenaline
What’s reserpine?
Extracted from Indian snake root plants
- used as a tranquiliser and for treating high blood presssure
- found to produce severe, often suicidal, depression
1960s - found that reserpine depletes monoamines in the brain - no adrenaline, dopamine and serotonin
Prevents their storage in the terminal prior to release
Deppresion is associated with what that decreases?
Serotonin and noradrenaline function
And drug treatment should aim to increase these neurotransmitters
Drugs which block MAO prevent what to breakdown?
The breakdown of serotonin and noradrenaline which leads to an increase in their concentrations in the synapse
What does SSRI stand for, and what’s it used for?
Serotonin specific reuptake inhibitors
Generally first in line for treatment for depression
Depression with associated anxiety
What does NRI stand for, and what’s is it used for?
No adrenaline reuptake inhibitors
May be better in patients who show depression with apathy
What does SNRI stand for, and what’s it used for?
Serotonin and noradrenaline reuptake inhibitors
Used for patients who do not reposed well to SSRI
