Week 13 - Mood Disorders P2 Flashcards
(23 cards)
What are selective serotonin re-uptake inhibitors (SSRIs)
- most commonly prescribed antidepressants e.g. fluoxetine – Prozac
- Selectively blocks serotonin reuptake pump – preventing serotonin from being reabsorbed after it’s release into the synaptic clef (serotonin remains available longer
- Comparable effects to TCAs but TCAs more effective for severe depression
What are other antidepressants
- serotonin and noradrenaline reuptake inhibitors (SNRIs
- Noradrenaline reuptake inhibitors (NARIs)
- St John’s wort (hypericum)
What are serotonin and noradrenaline reuptake inhibitors (SNRIs)
Inhibit serotonin and noradrenaline reuptake and treats a wider range of symptoms
o may cause nausea, dry mouth, dizziness, fatigue, loss of appetite, reduced libido
What are noradrenaline reuptake inhibitors (NARIs)
Inhibits the neuronal reuptake of noradrenaline - Increase noradrenaline.
o Causes Raise blood pressure and heart rate.
What is St John’s wort (hypericum) as an antidepressant
weak Herbal NA/serotonin reuptake inhibitor.
o Risk: Serious drug interactions – enhance drug metabolism by liver, can reduce effectiveness of other drug treatment (antibiotic, anti-diebetic, anti convulsive
o Similar efficacy to other antidepressants with fewer acute side effects
o Not likely to increase bleeding like other complementary medicines (feverfew, glarlic, ginger, gingko)
What is transcranial direct current stimulation (TDCS) as a novel experimental treatment for depression
o Non-invasive neuromodulation technique - brain stimulation of DLPFC.
o Involves administration of well tolerated electrical current to the brain through scalp electrodes targeting dorsolateral prefrontal cortex (DLPFC)
o DLPFC is involved in decision making and often less active in depression
o Promotes neuroplasticity and mood improvement. – grey matter increase
What is bipolar disorder
unusual shifts in a mood, energy, activity levels and concentration
* Alternating manic episodes and depressive episodes.
* Diagnosed in late adolescence or early childhood.
* requires lifelong treatment.
* Common associated with: Anxiety, ADHD, substance use or eating disorders – multifactorial onset
What are manic episodes
extremely up, elated, irritable or energised behaviour including psychotic symptoms
What are depressive episodes
down, sad, indifferent or hopeless
What are the main medications for bipolar disorder
- Lithium
- Antiepileptics
What is lithium as medication for bipolar disorder
Main mood stabilizer; narrow therapeutic window.
o Main drug in prevention and management of mania and cyclic depressive states
o Neuroprotective and neuroproliferative effects
o Drug interactions (NSAIDs, antibiotics), serotonin syndrome risk.
What is antiepileptics as medication for bipolar disorder
(lamotrigine, valproate): Alternative mood stabilizers. – managing mood swings
- Safer than lithium
What is fear
natural response to a specific, identifiable and immediate threat. Comprises defensive behaviours, autonomic reflexes, arousal and alertness and corticosteroid secretion.
What is anxiety
responses occur in an anticipatory manner, e.g. independent of what is actually happening at the time
Anticipatory response; more diffuse.
What are the different types of anxiety disorders
- Generalized anxiety disorder (GAD)
- Panic disorder
- Social anxiety disorder
- Phobias
- Obsessive-compulsive disorder (OCD)
What is generalized anxiety disorder
- Persistent state of excessive anxiety lacking any clear reason or focus
- Prolonged > 6 months – excessive worry that is not easily controlled
o Symptoms: Muscle tension, hypervigilance, restlessness, hyperactivity (e.g. sweating, palpitations, dry mouth), exaggerated startle response and inability to concentrate
What is panic disorder
o Sudden intense fear,
o Involving neurotransmitters serotonin, noradrenaline and GABA
o Serotonin levels appear low making SSRIs effective over 3 months.
o Noradrenaline appears to play a role – increased noradrenaline release may precipitate an attack
Symptoms
- Numbness or tingling in hands and fingers
- Feeling out of control
- Racing heart
- Feeling sweaty or chilled
- Feeling sweat
- Ringing in your ear
- Chest tightness and pain
- Difficulty catching your breath
- Feeling a sense of impending death
What is social anxiety disorder
o Persistent fear of being scrutinized or negatively evaluated by others
o Anxiety when exposed to a feared social situation and subsequence avoidance of the situation interferes with normal life
o Common in employment and school
o Drug or alcohol problem in approx. 50% of individuals
o Treatment: SSRIs, benzos, MAOIs effective in managing symptoms
o beta-blockers useful in specific social situations
What are phobias
o Irrational fear of specific objects/situations.
o Often evolve from untreated panic attacks (e.g., agoraphobia – anxiety in public or crowded places)
o Uses nomophobia test
What is obsessive compulsive disorder (OCD)
o Characterised by obsessions (repeated thoughts) and compulsions (repeated actions).
o Usually time consuming or distressing – individual recognises rituals are unreasonable
o Linked to serotonin deficiency;
o treated with SSRIs (or other antidepressants) + therapy.
What is Post-traumatic stress disorder ( PTSD)
Response to extreme trauma; includes re-experiencing, avoidance, hyperarousal.
o A standalone condition rather than anxiety disorder
o Diagnosis based on exposure to extreme stress or trauma + sings of intrusion, avoidance and hyperarousal present together for at least 1 month
o Linked with increased inflammation – subsequent major disease risk (e.g IBS)
What is the treatment for PTSD
o Treatment: Coping therapies, SSRIs, benzos.
o SSRIs to manage depressive symptoms
o Benzos for acute management
What is psychedelic assisted therapy for anxiety and depression
- A group of therapeutic practices involving psychedelics taken under therapeutic supervision from physicians, psychologists and other
- Used under supervision for anxiety/depression in terminal illness.
- Psilocybin, LSD: May reduce symptoms and existential distress for people with life threatening disease
- MDMA (ecstasy): Limited data; no severe side effects reported.
- No severe engative side effects of psychedelic assisted therapy
