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2015-04-27 22:35:32

cards for chp 13 - antidepressants
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  1. What is MDD?
    Major Depressive Disorder; mood disorder involving symptoms of depression
  2. Risk Factors for Depression: Male vs. Female, Suicide rate
    • Women:
    • 2x more likely to get depression than men; feelings of worthlessness, excessive guilt

    • Men:
    • tiredness, irritability, more likely to turn towards drugs 

    Suicide rate est. 5x greater
  3. 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
  4. 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)
    • iproniazid

    • Tuberculosis
    • Liver
  5. 2nd Gen. Antidepressants - 

    also known as?
    first one marketed?
    • SSRIs (Selective Serotonin Reuptake Inhibitors)
    • Fluoxetine(Prozac), alter personality
  6. 3rd Gen. Antidepressants - 

    also known as?
    Helpful for those who experience _____ with depression
    Atypicals; SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)

    fatigue, loss of energy
  7. 1st Gen Neurophysiology

    _____ the activity of monoamine oxidase

    Increase availability of ___, ___, and ___

    Inhibit ___-_ and ___-_
    inhibit (block)

    DA, NE, 5-HT

    MAO-A, MAO-B
  8. TCA (1st Gen) Neurophysiology

    block _______ on the ______ of ___ and ____
    reuptake transporter proteins; terminal buttons; 5-HT; NE
  9. 2nd Gen. Neurophysiology

    SSRIs _____ the ability of ______ cells to reabsorb and recycle _____

    Changes in ______ = antidepressant effects
    Changes in ______ = unpleasant side effects
    diminish; 5-HT

    • 5HT-1A
    • 5HT-2A
  10. 3rd Gen. Neurophysiology

    SNRIs and atypicals _____ the reuptake of __, __, ___, and ____
    block; 5-HT; NE; DA
  11. Pharmacokinetics:

    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 =
    • 1-3 hrs
    • 4-8 hrs

    • protein
    • first pass

    • 2-4 hrs
    • 24 hrs
    • 15-25 hrs
  12. 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
  13. What is Seratonin Syndrome? Symptoms?
    acute increase in serotonergic transmission

    • symptoms: 
    • disorientation, agitation, confusion, increased BP, flushing, fever, shivering, irregular heartbeat, diarrhea, shock
  14. 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
  15. SSRI effects on the periphery

    nausea, GI problems, headache, dizziness, sweating, nervousness, agitation

    vivid dreams, reduced REM sleep
  16. Subjective Effects:

    at low doses?

    at high doses?
    low - tiredness, apathy, weakness

    high - impaired comprehension, confusion
  17. Effects on Performance?

    TCA - negatively effects cognitive memory, psychomotor impairment related to sedation

    SNRI -  improved memory performance than SSRIs
  18. Placebo Effect

    Can account for up to __% of effectiveness

    Placebo respondent rates are as high as __% compared to __% response rate in drug treated individuals

    30%; 50%
  19. Nonhumans and TCAs - 

    Operant Response Rates?
    Punish-Suppressed Behavior?

    Discriminative Stimulus
    • increase
    • decrease

    no generalization to other drugs
  20. Tolerance develops in _____ to _____
    weeks; side effects
  21. Withdrawal symptoms:
    restlessness, anxiety, chills, akathisia (compulsion to move), muscle aches
  22. Other Treatments for depression
    herbs, Electroconvulsive therapy (ECT), deep brain stimulation, CBT, psychodynamic therapy,interpersonal therapy