Major Depression - recurring and disabling. Symptoms must last for at least two weeks and impair one's
ability to interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable
activities.
Chronic Depression - - less disabling than major depression, but symptoms can last longer, sometimes
being unhappy for two years. More common in women, affects 10.9 million people.
Atypical depression - rather than the other two, is characterized less by pervasive sadness and more by
overeating, oversleeping, sensitivty to rejection
Manic depression - depression oscillates between major depression and epsidoes of mania/ extreme
elation
Seasonal Affective Disorder - - often occurs wehre winters are short or there is a big change in the
amount of sunlgiht, and often treated with light therapy.
Diagnosis of Depression requires must have one of the top two and at least ____ other symptoms nearly
_____ for at least ___ weeks - MUST HAVE one of the top two
AT LEAST five of the other symptoms
Nearly DAILY
For at least TWO WEEKS
Causes of Depression - Genetics, death/psychosocial stress, medicine side effect
What kinds of drugs can cause depression as a side effect - Drugs like antihypertensives, oral
contraceptives, and Accutane for acne can cause depression
, Dosing schedule of antidepressants - what constitutes an adequate trial - slow low and increase rapidly
to target dose, maintain for 4-8 weeks
Which have known therapeutic drug levels? - Imipramine, desipramine, nortriptyline, amitriptyline
(possibly) all other unknown currently
How do antidepressants work? - synaptic pharmacology
Acute effect involves reuptake or degradation of ____ in the post synaptic ______ receptor -
monoamines in alpha 1
Chronic effects involve down regulation of _____ synaptic receptors, and alteration of protein synthesis
and messenger systems - post
The monoamine hypothesis suggests what? - Monoamine hypohtesis suggests that small amount of
neurotransmitter causes depression
the Receptor Sensitivity Hypothesis suggests what? - Supersensitivity and up-regulation of post-synaptic
receptors leads to depression
the sensitivity of the postsynaptic receptors to the NE and 5-HT neurotransmitters fluctuate to have
periods of hypersensitivity and also decreased response
Pharmacokinetics of antidepressants are what? - Absorption is rapid
Metabolism: extensive 1st pass
Oxidation, hydroxylation, demethylation
5% = "slow acetylators"
Protein bound: 90 - 95%
***a lot of drug interactions since protein bound
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