Depression

Question 1

What is unipolar depression?

Answer 1

When the mood change is only in one direction

Question 2

What is bipolar depression?

Answer 2

When the mood can change drastically in multiple directions

Question 3

Name four classes of anti-depressive drugs.

Answer 3

1) SSRI
2) Tricyclic AD
3) Monoamine oxidase inhibitors
4) 5-HT - NA reuptake inhibitor

Question 4

What is the basis for the monoamine hypothesis?

Answer 4

Depletion of 5-HT and NA in the brain
(excess in mania)

Question 5

How can reserpine stabilise mood?

Answer 5

It blocks the vesicular reuptake of 5-HT and NA

Question 6

What is a monoamine oxidase?

Answer 6

An enzyme that catalyses the deamination of of 5-HT, NA and DA

Question 7

What are the types of MAO and what do they act on?

Answer 7

MAO-A acts on DA and phenylethylamine
MAO-B acts on 5-HT, NA, DA and tyramine

Question 8

How can an MAO inhibitor decrease depression symptoms?

Answer 8

Preventing the depletion of neurotransmitters, thus decreasing symptoms

Question 9

What should people on MAOIs not eat?

Answer 9

High tyramine foods, such as cheese

Question 10

What makes a drug a tricyclic antidepressant?

Answer 10

It has 3 benzene rings

Question 11

Name a tricyclic AD

Answer 11

Imipramine

Question 12

Does imipramine work for both mania and depression?

Answer 12

No, only for depression

Question 13

How does imipramine cause its effects?

Answer 13

Primarily, it blocks uptake 1 but can cause side effects when it blocks uptake 2

Question 14

What can happen when imipramine binds to H1 receptors?

Answer 14

A sedative effect

Question 15

What happens when imipramine binds to α-1 and 2 receptors?

Answer 15

It induces postural hypertension

Question 16

What happens when imipramine binds to mACh receptors?

Answer 16

It can cause a dry mouth, blurred vision and constipation

Question 17

How do SSRIs exert their effects?

Answer 17

They block the reuptake channel of 5-HT

Question 18

What are the classes of RIs?

Answer 18

1) 5-HT+NA RI
2) NA selective RI
3) NA+DA RI

Question 18

How common is overdosing on SSRIs?

Answer 18

Infrequent as they are hard to overdose on

Question 18

What are some common side effects of SSRIs?

Answer 18

GI issues and lowered libido

Question 19

What is a potentially dangerous risk in children, when taking SSRIs?

Answer 19

Increased suicide risk

Question 20

What is it called when excessive- but not fatal- overdoses of SSRIs are taken?

Answer 20

Serotonin syndrome

Question 21

Which drugs can also block the reuptake of neurotransmitters?

Answer 21

Cocaine and amphetamine

Question 22

Name 5 atypical antipsychotics

Answer 22

1) Trazodone
2) Mirtazapine
3) Mianserin
4) Bupropion
5) Venlafaxine

Question 23

What are some characteristics of bupropion?

Answer 23

It is neither sedative nor euphoric. It is a NDRI It has DA

Question 24

What are some characteristics of venlafaxine?

Answer 24

It is an SNRI It is fast acting

Question 25

Why are St John's Worts not good?

Answer 25

They are homeopathic and contain an unknown concentration of hyperforin, therefore can have side effects

Question 26

Are there genetic factors involved with depression?

Answer 26

Yes, there is a ~37% inheritability, but there are no discernable treatments for this

Question 27

Which receptors does mianserin antagonise?

Answer 27

α-1, α-2, 5-HT2a and H1

Question 28

Which receptors does mirtazapine antagonise?

Answer 28

α-2, 5-HT 2c and 3 Also claimed to have fast onset

Question 29

What class of drug, other than being atypical AP, is trazodone part of?

Answer 29

Noradrenergic and specific serotonergic antidepressant

Question 30

Which receptors does trazodone block?

Answer 30

5-HT 2a and 2c and H1

Question 31

Comment on trazodone as a reuptake blocker

Answer 31

It is a weak 5-HT reuptake blocker

Question 32

Which neuroendocrine pathway is thought to be dysnfunctional in depression?

Answer 32

The hypothalamic-pituitary axis

Question 33

Neurotrophy in which brain regions is associated with depression?

Answer 33

Neuronal loss in the hippocampus and prefrontal cortex

Question 34

What can stress result in an increase of?

Answer 34

CRF, Cortisol and glutamate

Question 35

How does an increase in CRF, cortisol and glutamate result in depressive symptoms?

Answer 35

Via a complex signalling pathway, it results in increased neural apoptosis and decreased neurogenesis

Question 36

What are three promising future therapies for use in depression?

Answer 36

1) Circadian rhythm treatment with melatonin 2) Ketamine infusion 3) ECT/ TMS

Question 37

Which drug classes can be useful in stabilising mood in bipolar?

Answer 37

Anti-epileptics, Atypical antipsychotics and lithium

Question 38

How is lithium thought to help in bipolar disorder?

Answer 38

It interferes with a wide variety of signalling pathways that results in promoted inhibition and reduced excitation

Question 39

Comment on the practicality of lithium as a mood stabiliser

Answer 39

It has a very narrow therapeutic window and it can be highly nephrotoxic