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Week 8
Depression
18
Psychology
Graduate
11/25/2013

Additional Psychology Flashcards


 

 


 

Cards

Term

Monoamine Hypothesis of Depression (deficiency of NE, 5HT & DA)

Definition

Reserpine produces depressive sx

Suicidal depression associated w/ low levels of serotonin metabolites

Tryptophan depletion reinstates depression in former depressed pts.

MAOI & tricyclic antidepressants boost levels of these neurotransmitters

SSRIs increase 5HT

Not enough neurotransmitters? Too many receptors?

Antidepressants boost levels of monoamines

Monoamine levels increase quickly in response to antidepressants

Cognitive response takes weeks to appear

Too many receptors?

Receptors are pathologically up regulated or sensitized

Once monoamine levels are chronically elevated, receptors desensitize & downregulate

Term
Monoamines
Definition

 

NE, DA, 5HT – all include amino group (NH2)

- All have similar structure

 

Derived from aromatic amino acids (tyrosine, tryptophan, phenylalanine) by decarboxylase enzymes

Precursors to monoamines

Term
MAOa
Definition

Deaminates (degrades) epinephrine, norepinephrine, 5HT & dopamine

Deaminates tyramine (potent releaser of NE)

Must be inhibited for anti-depressive effect

MAOa selective – Brofaromine (Consonar)

 

Term
MAOb
Definition

Deaminates dopamine

  Selective inhibition does not produce anti-depressive effect

MAOb selective – Selegiline (Eldepryl)

Term
MAO Inhibitors
Definition

Most are irreversible

Most are non-selective for MAOa/b

- Relatively selective for A at low doses

 

- Examples: 

Isoniazid (Laniazid) Anti-TB drug; First antidepressant discovered 

Benmoxin (Neurasil)

Phenelzine (Nardil)

Term
Dietary Sources of Tyramine
Definition

Cheese;

cured meats;

fish;

wine; 

chocolate; 

avocado;

banana 

Term
Why are tyramine-rich foods avoided when on MAOIs?
Definition

hypertensive crisis - very high BP; potential organ damage

Serotonin crisis - increased HR; hyperthermia/sweating; dialated pupils; twitching; headache/mental agitation 

Term
SSRI Side Effects
Definition

Usually appear early then fade as neurotransmitter-receptor sys adjust

Individual differences specific to the pt. & from drug-to-drug

Sexual dysfunction

Weight gain (usually 5HT2C affinity)

Cardiovascular effects

Increased suicidal risks in adolescents

- Not clear that this effect appears in adults

- Black box warning

 

Term
Brofaromine
Definition

- Consonar

- MAOI

- MAOa selective

Term
Imipramine
Definition

- Deprinol

- Tricyclic 

- first tested for use as antipsychotic

Term
Amitriptyline
Definition

- Elavil

- tricyclic

- inhibitor of 5HT & NE reuptake

- essentially inactive on DA transport

Term
Tricyclic Side Effects
Definition

Autonomic effects:

- Anti-cholinergic -- Blurred vision; Dry mouth; Constipation; Urinary retention

- Alpha 1-adrenergic receptor effects –- Orthostatic hypotension; Tachycardia (rapid heart beat): Inhibition of NE uptake (sinus node)& Block of mAch receptors

- Voltage-gated sodium channel -- Overdose can lead to seizures, coma, arrhythmias & heart attack

 

Term
Paroxetine
Definition

- Paxil

- SSRI

Term
Fluoxetine
Definition

- Prozac

- SSRI

Term
Sertraline
Definition

- Zoloft

- SSRI

Term
2nd Generation Antidepressants
Definition

- Bupropion (Wellbutrin)

- Amoxapine (Asendin)

- Maprotilinie (Ludiomil)

- Trazodone (Desyrel)

Term
Buproprion
Definition

- Welbutrin

- often added to or replaces an SSRI

- does not cause weight gain or sexual dysfunction

- helps w/ smoking cessation 

Term
Lithium
Definition
- effective against mania
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