Mood Disorders (Slattery) Flashcards
Difference between depression and Bipolar Disorder?
Bipolar has mania
Mania episodes include?
Amplified energy, euphoria, rapid speech, hyper sexuality, etx.
Unipolar Depression may occur?
Once or be recurrent with euthymia in-between
Monoamine Hypothesis of depression and problem?
Depression if insensitivity or lack of monoamines. Especially NE and 5-HT. Problem is that there is a delay between chemical effects and clinical ones.
Neurotrophic Hypothesis of mood?
Brain-derived neurotrophic factor (BDNF) are critical in regulation of neural plasticity resilience, and neurogenesis. Too little causes depression. Good support for idea.
Antidepressant classes of drugs?
TCAs
MOA inhibitors
SSRI’s
Dual-mech. drugs
Mood Stabilizing classes of drugs?
Lithium carbonate
Anticonvulsants
Atypical antipsychotics
Possible Ketamine uses in depression?
Fast acting symptom improvements
-possible side effects including hallucination and nightmares
How does Ketamine work?
NMDA channel receptor antagonist
Lithium Carbonate
Prevents mood swings in patients with bipolar disorder (Stabilization)
Antidepressant effects seen in some patients
Absorbed in GI tract and excreted in kidneys
Sensitive to water and electrolytes imbalance
Lithium Carbonate adverse effects?
- Fatigue, muscle weakness, slurred speech, ataxia, tremor
- Excessive thirst and urination
- Small TI so not much gap between helpful and therapeutic doses
- Watch carefully because sensitive to renal clearance (reabsorbed with sodium)
Anticonvulsants for Bipolar Disorder?
Valproic acid
Carbamazepine
Approved Prophylaxis for Bipolar Disorder?
Carbamazepine
Valproic acid
- Efficacy similar to lithium
- Better for rapid cycling bipolar disorder
- Can be combined with lithium for patients not responding to treatment
What should never be used as a monotherapy for Bipolar disorder?
SSRI’s
- May cause rapid onset of mania
- Patient should get prophylactic mood stabilizer as well if going to use SSRI’s
