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What is MDD?
Major Depressive Disorder; mood disorder involving symptoms of depression
Risk Factors for Depression: Male vs. Female, Suicide rate
- 2x more likely to get depression than men; feelings of worthlessness, excessive guilt
- tiredness, irritability, more likely to turn towards drugs
Suicide rate est. 5x greater
What is the MAO Hypothesis?
(Monoamine Theory of Depression) suggests tat depression was a result of reduced levels of activity in the medial forebrain bundle (NE, serotogenic, and dopaminergic fibers)
associated withe decreased numbers of 5HT-reuptake inhibitors, transporters, and receptors
1st Gen. Antidepressants -
also known as (2)?
First one marketed?
initially treated this disease?
caused damage to what organ?
- MAOIs (Monoamine Oxidase Inhibitors) and TCAs (Tricyclics)
2nd Gen. Antidepressants -
also known as?
first one marketed?
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- Fluoxetine(Prozac), alter personality
3rd Gen. Antidepressants -
also known as?
Helpful for those who experience _____ with depression
Atypicals; SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)
fatigue, loss of energy
1st Gen Neurophysiology
_____ the activity of monoamine oxidase
Increase availability of ___, ___, and ___
Inhibit ___-_ and ___-_
DA, NE, 5-HT
TCA (1st Gen) Neurophysiology
block _______ on the ______ of ___ and ____
reuptake transporter proteins; terminal buttons; 5-HT; NE
2nd Gen. Neurophysiology
SSRIs _____ the ability of ______ cells to reabsorb and recycle _____
Changes in ______ = antidepressant effects
Changes in ______ = unpleasant side effects
3rd Gen. Neurophysiology
SNRIs and atypicals _____ the reuptake of __, __, ___, and ____
block; 5-HT; NE; DA
peak blood lvls of TCA = __-__ hrs
peak blood lvls of SNRI = __-__ hrs
high lvls of _____ binding
goes through ______ metabolism
MAOI half life =
TCA half life =
SSRI half life =
MAOI effects on periphery:
tremors, dry mouth, weight gain, blurred vision, low BP, postural hypertension (fainting or dizziness when standing)
insomnia or sedation
potentiated by alcohol and some opioids
What is Seratonin Syndrome? Symptoms?
acute increase in serotonergic transmission
- disorientation, agitation, confusion, increased BP, flushing, fever, shivering, irregular heartbeat, diarrhea, shock
TCA effects on the periphery
dry mouth, constipation, blurred vision, ringing in the ears, retention of urine, excessive sweating
reduction in seizure threshold
treats insomnia, doesn't increase total sleeping time
SSRI effects on the periphery
nausea, GI problems, headache, dizziness, sweating, nervousness, agitation
vivid dreams, reduced REM sleep
at low doses?
at high doses?
low - tiredness, apathy, weakness
high - impaired comprehension, confusion
Effects on Performance?
TCA - negatively effects cognitive memory, psychomotor impairment related to sedation
SNRI - improved memory performance than SSRIs
Can account for up to __% of effectiveness
Placebo respondent rates are as high as __% compared to __% response rate in drug treated individuals
Nonhumans and TCAs -
Operant Response Rates?
no generalization to other drugs
Tolerance develops in _____ to _____
weeks; side effects
restlessness, anxiety, chills, akathisia (compulsion to move), muscle aches
Other Treatments for depression
herbs, Electroconvulsive therapy (ECT), deep brain stimulation, CBT, psychodynamic therapy,interpersonal therapy