Psychiatric Disorder: Depression

  1. What does chronic use of MAOI do?
    Downregulates 5HT, alpha and beta receptors, BUT upregulates cAMP activation--> greater receptor sensitivty = produces a response similar to # of receptors before or a greater magnitude
  2. MAOI's MOA?
    inhibits MAO to increase levels of NE and 5HT in presyn term--> more transmitter released
  3. Where do MAOI's work?
    presyn. terminal
  4. List the classes of pharmacotherapy for depression
    • 1. MAOI
    • 2. TCA
    • 3. SSRI
    • 4. SNRI
    • 5. 5HT antagonists
    • 6. Atypical Antidepressants
  5. What does the disregulation/low levels of NE and DA contribute to?
    anhedonia (lack of pleasurable feeling), decreased energy, memory impairment and executive function deficits.
  6. What do low lvls of 5HT contribute to?
    Disregulation of: appetite, sleep, libido, motor function, anxiety and aggression
  7. What are monoamines?
    Endogenously synthesized transmitters w/ amine groups. Two groups: catecholamine and indoalmine.
  8. What is the monoamine hypothesis of depression?
    It states that patients with depression have low levels of monoamines vs thsoe who don't have depression
  9. What are the 3 components of sleep architecture that is disrupted by depression?
    • 1. Increased time to sleep onset
    • 2. Little time in stage 3 and 4 deep sleep states
    • 3. Decreased REM latency (REM starts earlier)
  10. What symptom is the most prevalent and persistent in depression?
    Disruptions in sleep
  11. What is one problem with the dexamethasone challenge?
    There is a high rate of false + and -.
  12. Besides measuring cortisol levels and looking for sleep abnormalities, what is another test that can be administered to possibly depressed patients? Describe.
    Dexamethasone Challenge. Dexamethasone is a synthetic glucocorticoid that tricks the brain to think it is cortisol, which should cause negative inhibition and reduce cortisol levels. Depressed patients do not suppress cortisol secretion.
  13. True or false. Depressed pt. always has a problem with the HPA gland
  14. True or false. Depressed patients have high plasma levels of cortisol
  15. What does the increased secretion of cortisol indicate?
    A disruption in the hypothalamus-pituitary adrenal axis (HPA-axis)
  16. What occurs in abnormal neuroendocrine function?
    Hypersecretion of corticotropin releasing factor (CRF), which causes higher release of cortisol due to increased stress
  17. What % of pt have neuroendocrine abnormalities?
  18. What are 2 biological markers for depression?
    • 1. Test for Neuroendocrine function
    • 2. Sleep study to measure abnormality in sleep stages
  19. Describe the criteria for a major depressive episode vs disorder in terms of duration of suffering
    An episode is classified as an episode if the episodes occurs are spaced out by a minimum of 2 months.
  20. How many episodes must occur to be diagnosed as a major depressive disorder?
    2 or more
  21. How many symptoms must be present to qualify as a major depressive episode
    5 or more
  22. what % of the population has had a major depressive episode in their lifetime?
Card Set
Psychiatric Disorder: Depression
5223. 12/4/11