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Depression often involves which NT?
The amines: Sorotonin, Dopa, Norepi-
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What are the main theories of the cuase of depression?
- Increased sensitivity of postsynaptic amine receptors
- Increased sensitivity of presynaptic amine recpetors
- Decreased sensitivity of GC receptors do to stress causing rise in cortisol.
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What is the general theory for why antidepressants work?
The cause a compensatory down-regulation of amine NT and a decreased sensitivity of the pre and post syn amine receptors
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Amitriptyline
- Elavil
- Tricyclic
- Blocks reuptake of NT
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Nortriptyline
- Aventyl
- Tricyclic
- Blocks reuptake of NT
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MOA Inhibitors
MOA degrades NT, and the MOA inhibitor allows NT to remain in the cleft longer.
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MOA Inhibitor type A v. type B
- Type A: Used for treating depression
- Type B: Prolongs effects of dopamine
- Both relatively non selective
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SSRI's (3)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Selective for reuptake of Serotonin
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SNRI (3)
- Venlafaxine (Effecor)
- Mirtazapine (Remeron)
- Bupropion (Wellbutrin)
- Selective for Serotonin and Norepi- with out effecting dopamine reuptake
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Amitriptyline side effects
- Elavil
- Tricyclic, sedation and block ACh recpetors.
- Confusion, delirium, dry mouth, constipation, urinary retention, tachycardia,arrhythmias, orthostatic, high potential for fatal over dose.
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Nortriptyline side effects
- Aventyl
- Tricyclic, sedation and block ACh recpetors.Confusion, delirium, dry mouth, constipation, urinary retention, tachycardia,arrhythmias, orthostatic, high potential for fatal over dose.
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MOA Inhibitor side effects
- Hypertensive situation
- CNS excitation
- Anticholinergic effects
- Adverse effects when taken with fermented foods
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2nd Generation side effects
- Less sedation, but more GI problems
- Serotonin syndrome: sweating, shivering, movement disorders and muscle fasciculations
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Lithium
- Used to treat bipolar disorders
- May deecrease excitability by competing with other cations.
- Not metabolized in body, so risk of toxic levels causing seizures coma or death
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