Term
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Definition
Genetic vulnerability
Developmental/Behavioral factors
-Anger turned inward (Freud)
-Negative reinforcement leading to low self-esteem and negative cognitions
-Learned helplessness
Physiological factors |
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Term
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Definition
Dysthymia
Major Depression
Bipolar Disorder |
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Term
| Major Depression Neurobiology |
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Definition
Decrease in amount or availability of serotonin
HPA dysfunction
Excessive stimulation of glutamate excitotoxic action |
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Term
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Definition
STRESS, CRF, ACTH, Cortisol, Detrimental gene transcription response, neural apoptosis, depressive symptoms
&/or
STRESS, glutamate, NMDA receptors, neural apoptosis, depressive symptoms
neural apoptosis occurs in hippocampus & prefrontal cortex |
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Term
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Definition
Social withdrawal
Reduced activity
Statements related to feelings of guilt and worthlessness
Self depreciatory behavior
Eating pattern changes
Sleep pattern changes
Poor concentration and slowing of cognitive processes
Anhedonia (loss of ability to feel pleasure)
Hopelessness and helplessness
Suicide ideations/attempts |
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Term
| Antidepressant Medication: Tricyclics MOA & Ex |
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Definition
Decrease presynaptic reuptake of serotonin and norepinephrine.
Result: Increased availability of serotonin and norepinephrine.
Examples: Elavil, Tofanil, Sinequan |
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Term
| Antidepressant Medication: MAOI MOA & Ex |
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Definition
Decrease breakdown of serotonin, norepinephrine, and dopamine in synapse by monoamine oxidase.
Result: Increased availability of serotonin, norepinephrine, and dopamine.
Examples: Marplan, Nardil, Parnate |
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Term
| Antidepressant Medication: SSRI MOA & Ex |
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Definition
Decrease presynaptic reuptake of serotonin.
Result: Increased availability of serotonin.
Examples: Celexa, Prozac, Luvox, Paxil, Zoloft, Lexapro |
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Term
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Definition
Decreases presynaptic reuptake of serotonin and stimulates postsynaptic serotonin receptors
Result: Increased availability of serotonin. |
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Term
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Definition
Decreases presynaptic reuptake of serotonin and norepinephrine.
Result: Increased availability of serotonin and norepinephrine. |
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Term
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Definition
Activates serotonin receptor sites (i.e. serotonin receptor agonist).
Result: Increased action of serotonin. |
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Term
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Definition
Decreases presynaptic reuptake of norepinephrine and dopamine.
Result: Increased availability of norepinephrine and dopamine. |
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Term
| Antidepressant Medication: Tricyclics S & S |
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Definition
Hypertension with orthostatic hypotension
Anticholinergic effects (e.g. blurred vision, dry mouth, constipation, tachycardia, urinary retention) |
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Term
| Antidepressant Medication: MAOI S & S |
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Definition
Hypertensive Crisis
Dietary tyramine promotes release of norepinephrine.
Tyramine is metabolized by monoamine oxidase.
MAOI prevents this normal metabolism causing an excess of norepinephrine.
This excess results in excessive vasoconstriction and hyperstimulation of the heart. |
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Term
| Antidepressant Medication: SSRI S & S |
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Definition
Serotonin Syndrome
Serotonin toxicity caused by increased levels of serotonin or increased action at the receptor site.
Symptoms include agitation, confusion, hyperreflexia, fever, hallucinations, and potential death.
Cytochrome P-450 inhibition resulting in difficulty metabolizing medications and other toxins. |
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Term
| Electroconvulsive Therapy: Indications |
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Definition
Indications for use
To relieve depression during pregnancy
When unresponsive to antidepressant medications and psychotherapy
When a rapid response is needed (e.g. high suicide risk)
For elderly patients for whom antidepressants may be toxic |
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Term
| Electroconvulsive Therapy: MOA & Concurrent Meds |
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Definition
Increases gamma-aminobutyric acid (GABA) receptor antagonism.
Reduces glucose metabolism in bilateral anterior and posterior frontal areas
Medications used during treatment
Robinol: Dries secretions
Brevitol: Short-acting hypnotic
Succinalcholine: Muscle relaxant |
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Term
| Bipolar Disorder Neurobiology |
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Definition
Depression and mania are the result of different processes with one process similar to major depression and the other similar to psychotic disorders.
or
Bipolar Disorder is a specific form of neurotransmission dysfunction which results in loss in mood stabilization:
Genetic vulnerability to hypersensitivity of neurons
Kindling effect in which long-term external stressors have hypersensitized neuron receptor sites
Neuroinflammation
Hyperproduction of inositol, a brain chemical which deactivates genes that produce a hormone called PACAP |
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Term
| Bipolar Disorder Types S & S |
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Definition
Bipolar I: Characterized by at least one episode of mania and at least one episode of depression.
Bipolar II: Characterized by no episodes of mania, at least one episode of hypomania, and at least one episode of depression.
Rapid Cycling: Characterized by four or more episodes of mania and/or depression within one year. |
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Term
| Bipolar Disorder Components S & S |
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Definition
Depression: Same as for major depression.
Mania
Phase I: Hyperverbal, hyperactive, distractible
Phase II: Increased irritability, aggression, elevated mood, inappropriate laughter, decreased attention to hygiene and grooming, increased appetite, increased sexual drive, decreased sleep
Phase III: Flight of ideas, grandiose delusions, clanging/talking in rhymes, bizarre appearance |
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Term
| Bipolar Disorder Medications: Mood Stabilizer, Lithium (Eskalith, Lithobid) MOA |
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Definition
Decreases neuron receptor site sensitivity resulting from kindling. (competes w/NA & K ion channels, competes w/Ca receptor sites that release norep)
Increases brain 17-hydroxy-DHA (docosahexaenoic acid) formation which has an antiinflammatory effect.
Inhibits production of inositol. |
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Term
| Bipolar Disorder Medications: Mood Stabilizers, Antiepileptics MOA |
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Definition
Valproic Acid (Depakene): Increases GABA.
Carabamazepine (Tegretol): Inactivates sodium ion receptor channel inhibiting kindling effect.
Lamotrigine (Lamictal): Inactivates sodium ion receptor channel. |
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Term
| Bipolar Disorder Medications: Antipsychotics and Antidepressants |
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Definition
Decrease psychotic symptoms
Decrease depression symptoms |
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Term
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Definition
| : Drying, thinning hair with hair loss (lithium inhibits thyroid hormone synthesis), mild hand tremor, mild loss of appetite, mild thirst, polyuria (lithium is excreted by the kidneys), mild fatigue, temporary/mild nausea, weight gain. |
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Term
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Definition
Toxic level: > 2.0 mEq/liter of blood
Early signs of toxicity: Confusion, incoordination, diarrhea, nausea, and vomiting.
Toxicity: Fever, decreased urine output, hypotension, irregular pulse, ECG changes (inverted or flattened T wave), impaired consciousness, seizures, coma, death. |
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Term
Antiepileptics Side Effects
Valproic Acid
Carbazepine
Lamotrigine |
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Definition
Valproic Acid: Rash, thrombocytopenia, weight gain
Carbamazepine: Drowsiness, ataxia, agranulocytosis
Lamotrigine: Rash, ataxia, hepatic failure |
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