mood disorders and antidepressant drugs

Question 1

where is marcus aurelius

Answer 1

in front of the cerebellum, midline nuclei in the brainstem

Question 2

MRI data - The mean gray matter volume of the … is reduced
in patients with major depressive disorder (and also in bipolar disorder)

Answer 2

subgenual anterior cingulate cortex

Question 3

Note: stress can also alter … signalling

Answer 3

glutamatergic

Question 4

what do you need to check at regular intervals in lithium tx

Answer 4

renal and thyroid

Question 5

lithium is tx for

Answer 5

bipolar, acute mania, schizophrenia

Question 6

what is the risk order for mania switch? (precipitation of manic episodes)

Answer 6

TCAs > SNRIs > MAOIs > SSRIs

Question 7

(treatment-refractory severe depression with suicide risk)

Answer 7

electroconvulsive therapy

Question 8

NMDA glutamate receptor antagonist); approved for treatment-resistant depression; nasal spray

Answer 8

esketamine

Question 9

progesterone-related compound, positive modulator of GABAA receptors); approved for post-partum depression; intravenous

Answer 9

brexanolone

Question 10

what is a better version of citalopram

Answer 10

escitalopram

Question 11

triad pf schizophrenia

Answer 11

positive - hallucinations, delusions
negative - introversion, apathy, low-self-esteem, personal neglect
cognitive - working memory impaires, attention deficit, executive dysfunction

Question 12

what is current book with mental diagnoses criteria

Answer 12

DSM 5

Question 13

which is the domain of schizophreinia which is the most important predictor of outcome

Answer 13

cognitive dysfunction

Question 14

what eeg abnormality in schizophrenia

Answer 14

abnormal ERPs (event related potentials

Question 15

genes associated with schizophrenia

Answer 15

DISC 1
dysbindin
comt

Question 16

brain structural changes in schizophrenia

Answer 16

Larger ventricles and
smaller mesial temporal lobe structures

Question 17

which condition shows hypofrontality in cognitive tasks

Answer 17

schizophrenia

Question 18

diagnosis of schizophrenia

Answer 18

at least two of the following symptoms :

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic* behaviour
Negative symptoms (i.e. affective flattening, avolition…)

At least one of the symptoms must be the presence of delusions, hallucinations, or disorganized speech.

at least over 6 months of which active symptoms for a whole month

Question 19

which brain cells can be hyperactive in sch, leading to synaptic loss

Answer 19

microglia

Question 20

which inflammatory markers can be raised in episodes of sch psychosis

Answer 20

tnf alpha
il6
crp

Question 21

Schizophrenia is associated with a dual dopaminergic imbalance: hyperactivity in the … and hypoactivity in the…

Answer 21

striatum (mesolimbic pathway –ventral striatum and also in the dorsal striatum),

mesocortical pathway – frontal cortex (to the cortex)

Question 22

do schizophrenia pts make more or less dopamine

Answer 22

more

Question 23

dopamine receptors are the main targets of schizophrenia drugs. Which receptors

Answer 23

D2/D3

Question 24

which was the first neuroleptic drug? what is the new name for neuroleptic

Answer 24

chlorpromazine
anti-psychotic

Question 25

which antipsychotics as first choice for sch

Answer 25

atypical (also called 2nd generation

Question 26

atypical (also called 2nd generation) examples

Answer 26

risperidone, olanzapine,** clozapine**, quetiapine, paliperidone, **aripiprazole**

Question 27

all atypical antipsychotics have antagonist activity at which receptor other than dopamine

Answer 27

5HT2A

Question 28

Clozapine moa

Answer 28

Clozapine blocks D4 receptors with high affinity

Question 29

Aripiprazole moa

Answer 29

is a partial agonist at presynaptic D2 receptors (dampens them down) but an antagonist at D2 postsynaptic receptors (blocks them) so double action

Question 30

typical (1st gen) antipsychotics examples

Answer 30

chlorpromazine, thioridazine, fluphenazine, haloperidol, flupenthixol

Question 31

what are the extrapyridimal effects of antipsychotics and why

Answer 31

Extrapyramidal effects (EPS) (acute dystonias, parkinsonism, tardive dyskinesia) ; approx. 60% D2 receptor occupancy required for antipsychotic efficacy; if >80% D2 receptors are blocked, risk of EPS

Question 32

what is tardive dyskinesia

Answer 32

involuntary mvts in orofacial area

Question 33

involuntary mvts in orofacial area name

Answer 33

tardive dyskinesia

Question 34

Rise in prolactin due to antipsychotic can lead to

Answer 34

sexual dysfunction, galactorrhoea, amenorrhoea

Question 35

3 metabolic complications of atypical psychotics

Answer 35

Weight gain (atypicals) Dyslipidemia (atypicals) Type 2 diabetes (atypicals)

Question 36

clozapine and haloperidol have muscarinic affinity. what side effects result

Answer 36

dry mouth dry eyes etc

Question 37

examples of drugs that can be depot antipsychotics

Answer 37

fluphenazine decanoate or haloperidol decanoate

Question 38

main side effects of typical antipsych

Answer 38

extra pyridimidal effects

Question 39

main side effects of atypical antipsych

Answer 39

metabolic complications

Question 40

what is Neuroleptic malignant syndrome what is it associated with

Answer 40

mostly typical antipsychs hyperpyrexia muscle rigidity tremor confusion autonomic instability Occurs in up to 2-3% of patients taking antipsychotics (mostly typical drugs)

Question 41

30% schizophrenic patients do not respond to treatment ??? – drug of choice in drug resistance what dangerous side effect

Answer 41

clozapine agranulocytosis

Question 42

Schizophrenia is associated with decreased ...transmission in the cortex

Answer 42

Schizophrenia is associated with decreased glutamatergic transmission (hypoglutamatergic state in the cortex)