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Questions and Answers
What is a contraindication for the use of TCAs?
What is a contraindication for the use of TCAs?
What is the result of the interaction between TCAs and MAOIs?
What is the result of the interaction between TCAs and MAOIs?
Which of the following is a side effect of TCAs?
Which of the following is a side effect of TCAs?
What is the effect of aspirin on TCAs?
What is the effect of aspirin on TCAs?
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What is the effect of barbiturates on TCAs?
What is the effect of barbiturates on TCAs?
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Why should TCAs not be used with SSRIs?
Why should TCAs not be used with SSRIs?
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What is the characteristic of 75% of unipolar depression cases?
What is the characteristic of 75% of unipolar depression cases?
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Which type of depression is associated with suicidal thoughts?
Which type of depression is associated with suicidal thoughts?
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What is the main difference between unipolar and bipolar depression?
What is the main difference between unipolar and bipolar depression?
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According to the Monoamine Theory of Depression, what is the cause of depression?
According to the Monoamine Theory of Depression, what is the cause of depression?
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What is the name of the hypothesis that suggests depression is associated with insufficient central release of NA and 5-HT?
What is the name of the hypothesis that suggests depression is associated with insufficient central release of NA and 5-HT?
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What is the effect of Reserpine on the brain, according to the Monoamine Theory of Depression?
What is the effect of Reserpine on the brain, according to the Monoamine Theory of Depression?
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What is the likely cause of an abnormal pethidine metabolite?
What is the likely cause of an abnormal pethidine metabolite?
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What is the result of the interaction between Levodopa and MAOIs?
What is the result of the interaction between Levodopa and MAOIs?
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What is the effect of taking tyramine rich foods with MAOIs?
What is the effect of taking tyramine rich foods with MAOIs?
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What is the minimum amount of tyramine required to produce a reaction?
What is the minimum amount of tyramine required to produce a reaction?
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What is the resulting condition when TCAs interact with MAOIs?
What is the resulting condition when TCAs interact with MAOIs?
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What is the condition that occurs when MAOIs and SSRIs are taken together?
What is the condition that occurs when MAOIs and SSRIs are taken together?
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What is a common symptom of discontinuation syndrome related to SSRIs?
What is a common symptom of discontinuation syndrome related to SSRIs?
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Which of the following conditions is NOT treated by SSRIs?
Which of the following conditions is NOT treated by SSRIs?
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What is the primary reason for not combining SSRIs with MAOIs?
What is the primary reason for not combining SSRIs with MAOIs?
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What is the advantage of NRIs over TCAs?
What is the advantage of NRIs over TCAs?
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Which of the following is a characteristic of NRIs?
Which of the following is a characteristic of NRIs?
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What is the potential benefit of NRIs in depression associated with fatigue?
What is the potential benefit of NRIs in depression associated with fatigue?
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What is the effect of Bupropion on 5-HT activity?
What is the effect of Bupropion on 5-HT activity?
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What is a unique advantage of Bupropion compared to SSRI's?
What is a unique advantage of Bupropion compared to SSRI's?
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What is a therapeutic use of Bupropion besides major depression?
What is a therapeutic use of Bupropion besides major depression?
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What is the mechanism of action of Mirtazapine?
What is the mechanism of action of Mirtazapine?
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What is the effect of Duloxetine on uretheral tone?
What is the effect of Duloxetine on uretheral tone?
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What is the primary use of Bupropion in smoking cessation?
What is the primary use of Bupropion in smoking cessation?
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Study Notes
Types of Depression
- Mild Depression: Self-limiting, often resolves without treatment.
- Moderate Depression: Causes difficulties at home and work, impacting daily functioning.
- Severe Depression: Associated with serious symptoms, including suicidal thoughts.
Classification of Depression
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Unipolar Depression (Major Depression):
- Mood swings consistently in one direction.
- Affects approximately 75% of cases, generally non-familial.
- Symptoms include anxiety and agitation.
- Triggered by stressful life events; familial cases represent 25%.
- Endogenous depression often treated with antidepressants like lithium.
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Bipolar Depression (Manic-Depressive):
- Characterized by alternating episodes of depression and mania.
- Mania involves enthusiasm, self-confidence, and impulsive behavior.
- Mainly hereditary, typically manifests in early adulthood.
Mechanisms of Depression
- Associated with insufficient central release of norepinephrine (NA) and serotonin (5-HT).
- Development of the Biogenic Amine Hypothesis: Links depression to functional deficits of monoamine transmitters in the brain.
- Monoamine Theory of Depression: Proposed in 1965, correlates depression with deficits in monoamines and mania with excess monoamines.
- Drug interactions illustrate this theory; antidepressants enhance transmission while specific drugs can induce depression.
Side Effects and Interactions
- Discontinuation Syndrome: Abrupt discontinuation of antidepressants can lead to headaches, malaise, agitation, and flu-like symptoms.
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SSRIs Uses:
- Effective for depression, anxiety disorders, bulimia nervosa, PTSD, premenstrual dysphoric disorder, ADHD, and more.
- SSRIs inhibit liver enzymes, necessitating caution when combined with other medications like TCAs and MAOIs to avoid serotonin syndrome.
New Treatments and Drug Interactions
- NRIs (Selective Norepinephrine Reuptake Inhibitors) like Reboxetine and Tomoxetine, beneficial for noradrenaline deficiencies and have fewer cardiovascular effects.
- MAOIs: Can cause hypertensive crises when taken with tyramine-rich foods (e.g., aged cheese, red wine).
- Combination of drugs like amphetamines with MAOIs poses significant risks.
TCAs (Tricyclic Antidepressants)
- Major side effects include anticholinergic effects, cardiovascular arrhythmias, seizures, and potential for death.
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Interactions:
- Compete for plasma protein binding, affecting potency.
- Avoid combination with MAOIs due to risk of hypertensive crisis.
- Contraindications: Not recommended for patients with glaucoma or enlarged prostate.
Atypical Antidepressants
- Bupropion: Unique due to its stimulating effects, reducing sexual side effects common to SSRIs, and helpful in weight loss programs and smoking cessation.
- Tianeptine and Amineptine: Enhance 5-HT uptake; used in anxiodepressive states with faster onset of action.
- Mirtazapine (NaSSA): Acts on noradrenergic and serotonergic systems by blocking alpha-2 receptors, increasing NA and serotonin release.
Key Considerations
- Importance of managing drug interactions, especially with SSRIs and MAOIs to prevent severe side effects like serotonin syndrome.
- Understanding the classification of depressive disorders aids in choosing appropriate therapeutic interventions.
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Description
This quiz explores the different types of depression, including mild, moderate, and severe depression, as well as unipolar and bipolar depression. Learn about the characteristics of each type, including symptoms and causes.
