22 Questions
Which nucleus produces noradrenaline (norA)?
Locus coeruleus
During which state is the locus coeruleus (LC) silent?
Sleep
Which type of receptor is α2 in the noradrenergic system?
Gi/Go coupled
Which drug has a very long t1/2 and requires a significant washout period of 5 weeks?
Fluoxetine
Which drug is a relatively selective dopamine uptake inhibitor and is used for nicotine cessation and cardiovascular problems?
Bupropion
Which drug is an NMDA receptor antagonist and often requires 6 low dose injections for it to work within a day if effective?
Ketamine
What is suggested as the reason for the delayed anti-depressive effects of drugs, despite the fact that drugs change monoamine response within minutes?
Chronic adaptive changes to the drug result in antidepressive effect
What is the clinical use of antidepressants for mild depression?
Non-drug therapy
What is often the first choice for patients with side-effect problems, although patients may change if side-effect problems persist?
SSRI
What may be used for non-responsive patients, involving sterotaxic targeting, Cg25 target, bilateral electrodes, and Freq DBS?
Electrical stimulation
What is used to treat anxiety disorders, similar to drugs used for treating depression?
SSRI
What percentage of the population experiences depression at any given time?
Approximately 6%
Which theory of depression suggests a functional deficit in monoamines in the brain leads to depression?
Monoamine theory of depression
Which neurotransmitters are indicated to be important in depression based on the clinical effectiveness of antidepressant drugs?
Serotonin (5HT), norepinephrine (NorA), and dopamine
Which antidepressant drug class is exemplified by venlafaxine and claims better efficacy and fewer side effects than SSRIs?
5HT/NorA uptake inhibitors (SNRIs)
Which antidepressant drug class is commonly prescribed and generally has fewer problematic side effects compared to TCAs or MAOIs?
Selective serotonin reuptake inhibitors (SSRIs)
What limits the understanding of the pathophysiology and how antidepressant drugs alter it over time?
Lack of good animal models of depression
Which antidepressant drug class is not widely used due to side effects and interactions, including the 'cheese reaction' caused by increased tyramine levels?
Monoamine oxidase inhibitors (MAOIs)
Which type of antidepressant can have problematic side effects, including anti-muscarinic effects and potential for drug interactions?
Tricyclic antidepressants (TCAs)
What challenges the simple monoamine deficit theory of depression?
Drugs causing changes in monoamine levels within minutes do not produce antidepressant effects for 4-6 weeks
What is crucial for effective treatment of depression?
Understanding the potential side effects, interactions, and time required for antidepressant effects
What is the lifetime prevalence of depression?
Up to 12-15%
Study Notes
Understanding Depression and Antidepressant Medications
- Depression can manifest as sadness, irritability, and loss of interest in usual activities, with varying severity and potential for suicidal thoughts or actions.
- Approximately 6% of the population experiences depression at any given time, with a lifetime prevalence of up to 12-15%.
- The monoamine theory of depression, proposed in the 1960s, suggests that a functional deficit in monoamines in the brain leads to depression, influencing the development of antidepressant drugs.
- The clinical effectiveness of antidepressant drugs, such as those affecting serotonin (5HT), norepinephrine (NorA), and dopamine, indicates the importance of these neurotransmitters in depression.
- However, the simple monoamine deficit theory faces challenges, as drugs causing changes in monoamine levels within minutes do not produce antidepressant effects for 4-6 weeks.
- Lack of good animal models of depression limits the understanding of the pathophysiology and how antidepressant drugs alter it over time.
- Antidepressant drug classes include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), 5HT/NorA uptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).
- TCAs, such as amitriptyline and nortriptyline, can have problematic side effects, including anti-muscarinic effects and potential for drug interactions.
- SSRIs, like fluoxetine and citalopram, are commonly prescribed and generally have fewer problematic side effects compared to TCAs or MAOIs.
- SNRIs, exemplified by venlafaxine, claim better efficacy and fewer side effects than SSRIs, but evidence for this is unclear.
- MAOIs, while some of the oldest antidepressants, are not widely used due to side effects and interactions, including the "cheese reaction" caused by increased tyramine levels.
- Understanding the potential side effects, interactions, and time required for antidepressant effects is crucial for effective treatment of depression.
Test your knowledge of depression and antidepressant medications with this quiz. Learn about the symptoms of depression, the monoamine theory, neurotransmitters involved, and different classes of antidepressant drugs. Understand the side effects, interactions, and time required for antidepressant effects for effective treatment.
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