CNS Antidepressant Agents - Kelly 3 Flashcards Preview

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Flashcards in CNS Antidepressant Agents - Kelly 3 Deck (11)
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1

Affective disorders

Group of mental conditions that include depression and bipolar disorder
Characterized by changes in mood
Most prevalent form of mental illness in US/CAN
Can be exacerbated or triggered by stressful incident, idiopathic onset
Role of genetic factors unclear

2

Goals of pharmacotherapy for depression

Relieve symptoms
Prevent suicide
Restore optimal functioning
Prevent recurrance

3

Iproniazid

Used for tuberculosis
Found to have psychoactive properties
Slows breakdown of monoamine NT

4

Tricyclic and heterocyclic antidepressants

Discovered same time as iproniazid
Inhibit reuptake of Na and 5-HT in synapse
Some newer heterocyclic may do so more specifically

5

Monoamine oxidase inhibitors

Incase synaptic levels of NT: not broken down into metabolites
Can have hypertensive crisis due to increased stores of NE
Tyramine levels can increase (cheese reaction)
Risk of serotonin syndrome

6

Adverse effects of TCA

Excessive sedation
Antimuscarinic effects
Sympathomimetic effects
Orthostatic hypertension, EEG abnormalities

7

SSRIs

Selective Serotonin reuptake inhibitors
Used to treat depression, eating disorders, anxiety disorders, OCD
Fewer anticholinergic side-effects than TCAs

8

Adverse effects of SSRIs

Nausea
Headache
Anxiety, agitation
Insomnia
Sexual dysfunction

9

Mirtazapine

Has antidepressant/antianxiety properties
Blocks presynaptic alpha2-AR and increases NE and 5-HT release

10

Bupropion

Weaker inhibitor of DA, 5-HT, NE uptake
Few side effects
Frequently used for patients who want to quit smoking

11

Neurotrophic hypothesis of depression

Grown factors such as BDNF are critical to regulation of neural plasticity
Stress, pain, depression associated with decreased BDNF levels and structural atrophy in hippocampus, frontal cortex
Antidepressant drugs are associated with increased BDNF levels
Causes synaptogenesis with chronic administration
Driving release of GF in the brain which drives synaptogenesis in critical areas