Lecture 11 - Antidepressants Flashcards Preview

Pharmacology > Lecture 11 - Antidepressants > Flashcards

Flashcards in Lecture 11 - Antidepressants Deck (71)
Loading flashcards...
1

Drugs used as antidepressants

amitriptyline
imipramine
fluoxetine
paroxetine
sertraline
mirtazapine
buprorion
venlafaxine
phenelzine

2

List 3 types of depressive disorders

1 - reactive (secondary depression)

2 - bipolar disorder

3 - major depression

3

Describe:
1 - reactive (secondary depression)

-temporary rxn to real stimuli such as grief or illness
-treatment is largely by psychotherapy

4

Describe:
2 - bipolar disorder

-recurrent major depressive episodes with intervening manic, hypomanic, or mixed episodes

5

Describe:
3 - major depression

-one or more major depressive episodes free of manic, mixed or hypomanic episodes

6

Lifetime prevalence in males?

9.6%

7

Lifetime prevalence in females?

20.4%

8

____% of the population are at risk of experience a major depressive episode at any given time

3-5

9

Onset?

most frequently 25-44 years of age

10

____ % have a single episode

30-50

11

recurrent episodes in ____%

50-70

12

If a first degree relative has depression, how much more likely are you to get depression?

1.5-3 times more likely

13

Risk of major depression determined by inheritance = ?

39%

14

Risk of major depression determined by environment = ?

61%

15

List the 4 types of symptoms of major depression

1-emotional
2-physical
3-cognitive
4-psychomotor

16

Describe:
1-emotional

-diminished ability to experience pleasure
-loss of interest in usual activities
-pessimistic outlook
-anxiety (90%)

17

Describe:
2-physical

-chronic fatigue
-terminal insomnia
-appetite disturbances

18

Describe:
3-cognitive

-poor concentration
-slow thinking
-poor short-term memory

19

Describe:
4-psychomotor

-slowed physical movements and speech
-agitation

20

Diagnosis for depression?

have to have at least 5 symptoms of these over a period of 2 weeks to be diagnosed with depression

21

List 2 non-pharmacologic therapies for major depression

-psychotherapy
-ECT (electroconvulsive therapy)

22

Describe pharmacologic therapy for major depression

-50-60% of Pts responsive
-newer drugs well-tolerated and present little risk for OD
-all drugs have similar efficacy

23

Describe the amine hypothesis

depression is related to reduced synaptic levels of NE and 5-HT

24

What supports the amine hypothesis?

1) 1950's - Reserpine was proven to reduce NE and 5-HT metabolism and caused depression in 15% of patients

2) Most antidepressant drugs appear to work by enhancing synaptic monoamines (by blocking reuptake)

25

How long is the therapeutic lag for antidepressants?

1-4 weeks

26

Antidepressants have ___-term synaptic effects that influence synaptic strength

long

27

Describe Phase 1 amine enhancement

short-term (min-hrs)
uptake inhibition

28

Describe Phase 2 amine enhancement

long-term (weeks) effects of phase 1 enhancement - produces further enhanced amine levels to reach therapeutic significance

29

Explain "understand Phase 2"

-normal scenario - pre-synaptic receptors that feedback inhibit to stop amine release

-phase 1 causes homeostatic agonist down regulation of these receptors to maintain "normal" agonist:receptor interaction levels

-results in reduced negative feedback and phase 2 amine increase

30

Give examples of TCAs

**amitriptyline
**imipramine
clomipramine
doxepin
protriptyline
desipramine

**most important