Mood Disorders Flashcards
(20 cards)
What drugs can induce depression
B-blockers, CCB Benzodiazepines Methyldopa Corticosteroids Anabolic steroids
Egs of mood disorders
Major depressive disorder Bipolar mood disorder Dysthymia (over to years) in adult 1 in kids) 2ndry to medical conditions Substance induced
What amino acid is needed to make serotonin
Tryptophan
Eg of an SSRI
Fluoxetine
MOA of SSRI
Selective and potent inhibition of serotonin re uptake via inhibition of the serotonin transporter.
A/E for SSRIs
GIT - nausea, vomiting
Sexual - anorgasmia, delayed ejaculation, impotence
CNS - akathisia, psychomotor retardation, Parkinsonism, dystonic reactions. Agitation, anxiety, panic attacks.
Signs of serotonin syndrome
Neuromuscular hyperactivity- tremor, clonus, hyperreflexia
Altered mental state - agitation, excitement
Autonomic hyperactivity - fever, sweating, tachycardia, tachypnoea, diarrhoea
Two examples of TCAs
Amitriptyline
Imipramine
Contraindications for SSRI
Renal failure
MAOI therapy (5 week gap needed)
Pregnancy
Lactation
Indications for TCA use
Depression
Anxiety
Nocturnal enuresis
Analgesic (adjunctive) in chronic pain syndromes
MOA of TCAs
Inhibit the reuptake of noradrenaline and 5HT in central monoamine synapses.
Side effects of TCAs
M1 - constipation, dry mouth, blurred vision
H1 - weight gain, drowsiness
A1 - dizziness, hypotension
Result of TCA overdose
Coma
Seizure
Arrhythmias
Cardiac arrest
Indications for lithium
Prophylaxis of manic and hypomanic episodes
Augmentation of antidepressant therapy
Two egs of anticonvulsants used in management of mania
Sodium valproate
Carbamazepine
MOA of benzodiazepines
Enhance GABA transmission by:
- Allosteric enhancement of Cl conduction
- Increasing frequency of channel opening
- Therefore hyperpolarisation
Indications for benzodiazepines
Anxiety disorder Management of alcohol withdrawal Seizure disorders Muscle relaxant Acute sedation
ADRs to benzodiazepines
Common - drowsiness, over sedation, amnesia
Uncommon - depression, disorientation, confusion, slurred speech, lethargy, ataxia
Paradoxical (children) - hyperexcitability, agitation
Dependence [more common in short acting]
How to wean off benzodiazepines
Slow step wise reduction of dose by 10% every 2-4 weeks
What is used in benzodiazepine overdose and how does it work
Flumazenil. Binds competitively to the benzodiazepine receptor. Can cause benzodiazepine withdrawal leading to seizures.
