L67-68 Watts antidepressants

Question 1

3 types of depression and rough estimate of prevalency

Answer 1

reactive (60%)
Major depressive (25%)
Bipolar affective (15%)

Question 2

some physiological clinical features of depression

Answer 2

decreased sleep
appetite changes
fatigure
psychomotor dysfxn

Question 3

some psychological clinical features of depression

Answer 3

dysphoric mood
worthlessness
guilt
loss of interest/pleasure *

Question 4

2 cognitive clinical features of depression

Answer 4

decreased concentration
suicidal ideation

Question 5

“biogenic amine” hypothesis of depression:
- _________ causes depression by depleting ___ and ___ from vesicles

Answer 5

reserpine
NE
5HT

Question 6

“biogenic amine” hypothesis of depression:
agents that increase ___ and ___ are effective for treating depression

Answer 6

5HT and NE

Question 7

“biogenic amine” hypothesis of depression:
Genetic polymorphisms in ____ promotor

Answer 7

SERT

Question 8

“biogenic amine” hypothesis of depression:
Alterations in ________ and __ receptors

Answer 8

5HT1A/2C and a2

Question 9

neuroendocrine hypothesis of depression thing Watts said to know

Answer 9

know that HPA axis is involved and it is overactivity of HPA axis that causes excessive release of CRF (causes core depressive sxs)

Question 10

CRF acts on _____ receptors which leads to disruption of what 2 things

Answer 10

CRF1 receptors, sleep and sexual behaviors

Question 11

3rd neurotrophic hypothesis of depression key message according to Watts

Answer 11

Brain-derived neurotrophic factor (BDNF) is critical in neural plasticity, resilience, and neurogenesis

Question 12

dendritic ________ start to disappear in depression

Answer 12

sprouts

Question 13

Integration of hypotheses of depression (shit he wants us to know)
____ and ____ abnormalities regulate BDNF levels

Answer 13

HPA
steroid

Question 14

Integration of hypotheses of depression (shit he wants us to know)
Hippocampal glucocorticoid receptors are activated by _____ during stress which (increases/decreases) BDNF

Answer 14

cortisol
decrease

Question 15

Integration of hypotheses of depression (shit he wants us to know)
chronic activation of _____ receptors increases BDNF signaling

Answer 15

monoamine

Question 16

Integration of hypotheses of depression (shit he wants us to know)
chronic activation of monoamine receptors leads to a downregulation of the ____ axis

Answer 16

HPA

Question 17

how long does it take most antidepressants to show effects?

Answer 17

days to weeks
(next slide says 2-3 weeks)

Question 18

what two neurotransmitters are normally degraded by monoamine oxidase

Answer 18

NE and 5HT

Question 19

MAOis cause more NE and 5HT released from ______ into the _______

Answer 19

vesicles
synapse

Question 20

2 non-selective MAOi’s

Answer 20

phenelzine (nardil)
Tranylcypromine (parnate)

Question 21

2 MAO-B selective drugs

Answer 21

selegiline (eldepryl/ensam)
Safinamide (xadago)

Question 22

1 MAO-A selective drug

Answer 22

Moclobemide (manerix)

Question 23

Reversible
A. MAO-A
B. MAO-B

Answer 23

both

Question 24

used in europe but not here yet
A. MAO-A
B. MAO-B

Answer 24

A. MAO-A

Question 25

6 severe side effects of MAOi's

Answer 25

headache drowsiness dry mouth weight gain hypotension sexual dysfxn

Question 26

avoid what food for what purpose in MAO'is

Answer 26

tyramine bc of hypertensive crisis risk

Question 27

2 MAOi interactions with OTCs

Answer 27

cold preparations, diet pills

Question 28

3 drug classes that interact with MAOi's

Answer 28

TCA SSRI L-DOPA

Question 29

what main herbal product has MAOi activity and should be avoided

Answer 29

st johns wort

Question 30

Site of Action of Reuptake Blockers: Orthosteric site -> _____ binds

Answer 30

serotonin

Question 31

Site of Action of Reuptake Blockers: allosteric sites -> _____

Answer 31

antidepressants bind here and block NE and 5HT into synapse

Question 32

4 indications for TCAs

Answer 32

depression panic disorder chronic pain enuresis

Question 33

Why is OD/toxicity extremely dangerous in TCAs

Answer 33

depressed pts more likely to be suicidal *

Question 34

TCA/Tertiary Amine/Secondary Amine MOA

Answer 34

inhibit NE and 5HT reuptake via NET and SERT

Question 35

Also act as H1, a1, and antimuscarinic agonists A. Tertiary amine TCAs B. Secondary amine TCAs

Answer 35

A. Tertiary amine TCAa

Question 36

causes less general side effects than the other as a whole A. Tertiary amine TCAs B. Secondary amine TCAs

Answer 36

B. Secondary amine TCAs

Question 37

Imipramine: Tert or Sec amine

Answer 37

tertiary

Question 38

Amitriptyline: Tert or Sec

Answer 38

Tertiary

Question 39

imipramine metabolized into __________?

Answer 39

desipramine (a secondary amine)

Question 40

Amitriptyline metabolized into ________?

Answer 40

nortriptyline, a secondary amine

Question 41

Used for enuresis and ADHD A. Imipramine B. Amitriptyline C. Clomipramine D. Doxepin

Answer 41

A. Imipramine

Question 42

Clomipramine: Tert or Sec

Answer 42

Tertiary

Question 43

Doxepin Tert or Sec

Answer 43

Tertiary

Question 44

Used for OCD A. Imipramine B. Amitriptyline C. Clomipramine D. Doxepin

Answer 44

C

Question 45

Desipramine Tert or Sec

Answer 45

secondary

Question 46

Nortriptyline Tert or Sec

Answer 46

secondary

Question 47

Maprotiline Tert or Sec

Answer 47

secondary

Question 48

Better at targeting NET than SERT A. Tertiary B. Secondary

Answer 48

B. Secondary -> there is an "n" in secondary

Question 49

T or F: Opening Serotonin transporter pumps is a part of the MOA of SSRIs

Answer 49

false, they get blocked to keep 5HT in synapse longer

Question 50

I (cole) know the ssris so i'm skipping cards on that just so anyone else looking at this knows

Answer 50

sorry

Question 51

highlighted side effect of SSRIs

Answer 51

anxiety for some reason

Question 52

Vilazodone A. SSRI + 5HT1A partial agonist B. 5HT2 Antag/ SERT inhibitor

Answer 52

A

Question 53

Vortioxetine A. SSRI + 5HT1A partial agonist B. 5HT2 Antag/ SERT inhibitor

Answer 53

A