Pharmacology of anti-depressant drugs and mood stabilisers Flashcards Preview

Psychiatry > Pharmacology of anti-depressant drugs and mood stabilisers > Flashcards

Flashcards in Pharmacology of anti-depressant drugs and mood stabilisers Deck (25):
1

Name a MOAi

Iproniazid

2

What do appetitive/ approach systems do?

Function to mediate seeking and approach behaviours (including pleasure)

3

What do aversive/defensive systems do?

Function to promote survival in the event of threat (fear/pain)

4

What is the dorsal striatum responsible for?

Movement

5

What is the amygdala responsible for?

Conditioning/learning

6

What is the anterior cingulate responsible for?

The anterior cingulate cortex is responsible for reward anticipation, decision making, emotion, impulse control and empathy

7

What is the orbitofrontal cortex responsible for?

The orbitofrontal cortex is responsible for cognitive processing of decision making

8

Drug used to treat premature ejaculation

SSRI

9

How do SSRIs work?

Prevent the reupake of 5-HT
-increase synaptic 5-HT within hours

10

How long does it take to feel the effects of anti-depressant medications?

2-3 weeks

11

What are 5-HT1A receptors

These are auto-receptors found throughout the CNS
-they are inhibitory and more receptors means greater inhibition
-they may provide a plausible mechanism to explain the delayed effects of most anti-depressants

12

Name 2 SSRIs which inhibit CYP450

Fluoxetine
Paroxetine

( anti=psychotics which do this: phenytoin, carbamazepine)

13

One of the first antidepressant drugs was which category of drug?

TCA
-imipramine

14

Name an anti-psychotic which may act as an anti-depressant at a low dose

Flupentixol

15

Dopamine receptors involved in anti-depressants

D2 receptors

16

Main inhibitory neurotransmitter in the brain

GABA

- in the developing brain, its actions are primary excitatory

17

What does GABA binding cause?

GABA binding causes opening of ion channels - either Cl- ions into the cell or K+ ions out of the cell

-this leads to a negative change in the transmembrane potential --> hyperpolarisation

18

What are 'mood stabilisers'

Most mood stabilisers are anti-convulsant drugs
-the majority of mood stabilisers are more effective at reducing manic episodes than depressive episodes

19

List some anti-convulsant drugs

-carbamazepine
-valproate, sodium valproate
-lamotrigine

20

"atypical" or "second generation" drugs

-olanzapine
-risperidone
-aripiprazole
-quetiapine

21

How does lamotrigine work?

Blocking Na+ channels

-overall effect is to reduce excitability and cell firing (potentially useful if you have over-excitable neurons

22

One of the oldest mood stabilisers

Exact mechanism unknown:
-Inhibition of 5-­‐HT autoreceptors
-Increase in anti-­‐apoptotic factor Bcl-­‐2
-Inhibition of glycogen synthase kinase-­‐3 (GSK-­‐3)
-Depletion of inositol
Upregulation of glutamate re-­‐uptake

Lithium

23

IMPORTANT: Anti-psychotic mechanism of action

The true antipsychotic efficacy is related to their affinity of the D2 RECEPTOR

24

IMPORTANT: What is the desired effect of anti-psychotics

Desired effect is DA blockade in the MESOLIMBIC CIRCUITS

25

IMPORTANT: adverse effects of anti-psychotics?

Adverse effects (e.g. movement disorders, hyperprolactinaemia) are due to DA BLOCKADE in the NIGROSTRIATAL and TUBERO-INFUNDIBULAR PATHWAYS