Mood Disorders Flashcards Preview

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Flashcards in Mood Disorders Deck (23):
1

Major Depressive Episode

5+ sx in same week and change in functioning

2

Persistent Depressive Disorder

Depressed mood + 2 sx >1 year

3

Bipolar Disorder/Manic Depression

3+ sx greater or equal to 1 week

4

MAO hypothesis

Low monoamines DA, NE, SR

5

Dysregulation hypothesis

Dysregulation of postsynaptic receptors due to abnormal neurotransmitter concentrations

6

Neuroendocrine hypothesis

Hypothyroidism and dysfunctional HPA axis (high cortisol levels but limited stress response to dex challenge)

7

Key components of antidepressant pharmacology

Alleviate depressive sx, not CNS stimulant
Neurostransmitter levels increase rapidly, but sx not reduced for weeks
Sudden d/c = rapid withdrawal sx

8

Measuring Response/Onset of Effects

Week 1: appetite, sleep,
Weeks 2-3: drive and concentration
Weeks 4-6: mood and hopelessness

9

Best indicator of clinical response?

Fatigue

10

How long is an adequate trial of antidepressants?

8 weeks

11

TCAs Side Effects

Hypotension/increased HR - alpha
Wt gain - His
Lower seizure theshold - GABA
AntiAch - m

12

TCAs MOA

Block reuptake of NE and SR

13

MAOi MOA

Block degradation of NE, SR and DA

14

Selective vs Non-Selective MAOis

MAOa and MAOb
Selegiline - MAOb only - less dietary restrictions

15

MAOi Drug Interaction

Tyramine! - HTN crisis

16

Serotonin Syndrome

Abdominal pain
High HR and BP
Changes in MS
Tremor
Diarrhea

17

SSRI Side Effects

GI upset
Stimulant (paxil - sedation)
Weight loss
Low libido

18

SSRI Withdrawal

Flu like syndrome
TAPER

19

NDRI

Wellbutrin
DA > NE >>>>>>>>> SR reuptake blockers

20

SNRI

SR NE Reuptake Inhibitor

21

SARI

SR antagonist and reuptake inhibitor!
Trazodone

22

NSSA

Noradrenergic Specific Serotonin Antidepressant
Mirtazapine
Increases neurotransmitter levels
Anti-histamine activity = sedation and weight gain

23

Drugs use to augment antidepressants

Lithium
Pindolol
Stimulants
Atypical Antipsychotics
Synthroid
Anticonvulsants