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14 Cards in this Set

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What are the drugs used to treat depressive disorders? x5
SSRI

SNRI

MAOI

TCA

Atypical Antidepressants
What are the drugs used to treat mania and bipolar disorder? x3
Lithium

Anti-epileptics,
Benzodiazepines
Carbamezapine

Valproic acid (anti-convulsive)
ECT
Discuss the catecholamine hypothesis of affective disorders.
Increased catecholominergic activity is associated with elevated mood.

Decreased catecholominergic activity is associated with depression.
Evidence for the catecholamine hypothesis. x2
Agonist (e.g. - amphetamine) elevate mood.

Amine-depleting drugs (e.g. - reserpine) depress mood.
Evidence against the catecholamine hypothesis. x3
Effects of amine depleting drugs (e.g. - reserpine) do not mimic depression.

Depression is associated with increased catecholaminergic activity.

Mania is not associated with increased NE activity.
Biological markers of depression. x4
Cortisol elevation

CSF MHPG elevation

Escape from Dexamethasone suppresion

Tryptophan low
TCA

- physiological mechanism
- antimuscarinic side effect x6
- antihistaminergic side effect
- anti-alpha1-adrenergic side effect x2
Inhibition of NE and serotonin reuptake

Blurry vision
Confusion
Dry mouth
Constipation
Urinary retention
Mild tachycardia

Sedation

Postural hypotension
Sedation
SSRI

- physiological mechanism
- side effects
Selective inhibition of 5-HT reuptake

Sexual dysfunction
Insomnia
Nervousness, anxiety
What are the symptoms of Serotonin syndrome? x4
Cardiovascular collapse
Hyperthermia
Agitation
Tremor
What is the Corticotropin Releasing Factor Hypothesis of Depression.
Depression is caused by hypersecretion of CRF from neurons in the brain.
Based on the Corticotropin Releasing Factor Hypothesis, Depressed patients exhibit:

- Plasma cortisol
- Dexamethasone
- CRF responsiveness
- CRF concentration in CSF
- CRF receptor concentration
Elevated cortisol

Decreased sensitivity to dexamethasone

Increased responsivity to CRF

Increased CSF concentration of CRF

Decreased CRF receptor concentration
Many depressed patients exhibit what in the urine?
Increased NE and MHPG excretion.
Lithium

- physiological mechanism
Inhibits inositol phosphate phosphatase,

thus preventing inositol recycling.

thus inhibiting NT-stimulated adenylyl cyclase
Lithium

- therapeutic range
- sensitive to what drugs
0.5 to 1.0 mM (toxic >1.5 mM)

Diuretics and anti-inflammatory drugs