22 Questions
What is the predominant emotional state over time?
Depression
Which nucleus produces noradrenaline?
Locus coeruleus
Which receptor type is Gs coupled?
Β1
What is the recommended washout period for fluoxetine due to its long half-life?
5 weeks
Which antidepressant is relatively selective for dopamine uptake inhibition and is also used for nicotine cessation?
Bupropion (Zyban)
What is the proposed reason for the delayed onset of antidepressant effects despite rapid changes in monoamine response?
Chronic adaptive changes to the drug
What is the approximate percentage of Australians taking antidepressants?
10%
For which type of depression is non-drug therapy recommended?
Mild depression
Which class of antidepressants is often the first choice, but patients may consider switching due to side-effect problems?
SSRI
What may be used for non-responsive patients, targeting the Cg25 region with bilateral electrodes?
Electrical stimulation
Which drugs are used to treat anxiety disorders, similar to those used for depression?
Similar drugs to those used for depression
Which theory of depression suggests a functional deficit in monoamines in the brain leads to depression?
The monoamine theory
What is the approximate lifetime prevalence of depression?
12-15%
Which neurotransmitters are indicated as important in depression based on the clinical effectiveness of antidepressant drugs?
Serotonin (5HT), norepinephrine (NorA), and dopamine
Which class of antidepressants is commonly prescribed and generally has fewer problematic side effects compared to TCAs or MAOIs?
Selective serotonin reuptake inhibitors (SSRIs)
Which antidepressant class claims better efficacy and fewer side effects than SSRIs, but with unclear evidence for this claim?
5HT/NorA uptake inhibitors (SNRIs)
Which class of antidepressants is not widely used due to side effects and interactions, including the "cheese reaction" caused by increased tyramine levels?
Monoamine oxidase inhibitors (MAOIs)
What is the major limitation in understanding the pathophysiology of depression and how antidepressant drugs alter it over time?
Lack of good animal models of depression
Why does the simple monoamine deficit theory face challenges?
Drugs causing changes in monoamine levels within minutes do not produce antidepressant effects for 4-6 weeks
What are the potential side effects of tricyclic antidepressants (TCAs)?
Anti-muscarinic effects and potential for drug interactions
Why are MAOIs not widely used?
They have side effects and interactions, including the "cheese reaction" caused by increased tyramine levels
What is crucial for effective treatment of depression?
Understanding the potential side effects, interactions, and time required for antidepressant effects
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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