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Antidepressant Drugs Notes

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Lecture 45 Antidepressant Drugs

Types of mood/affective disorder o Depression (monopolar)
 Symptoms

• Emotional- Mood; Thought disorder

• Biological- Anhedonia (failure to feel reward)

• Cognitive- Difficulty decision making; Poor concentration
 Drug treatments aim to improve mood and motivational impairments o Mania (monopolar) and bipolar disorder
 Symptoms

• Sleep changes

• Excessive exuberance, enthusiasm and confidence, grandiosity

• Increased libido

• Behaviours inappropriate to circumstances

• Disorders of thought (psychosis)
 Drugs aim to control excessive oscillations in mood Depression o Causes
 Chemical imbalance

• Monoamine theory (transmitters are dysfunctional)

• Functional deficit in 5-HT and/or NA (possibly DA)
 Neurodegenerative

• Neural apoptosis and neurogenesis
 Immune response (sickness behaviour)
 Genes
 Environment (stress) o Treatments
 Pharmacological

• Enhance monoamine levels in CNS o Post-synaptic agonist (Buspirone- not antidepressant) o Pre-synaptic receptor antagonist (e.g. Mirtazipine) o MAO inhibitors (Moclobemide=reversible; phenylzine) o Re-uptake inhibitors (e.g. fluoxetine, venlafaxine) o Reuptake=most common target area

• Specific receptor agonists/antagonists
 Cognitive behavioural therapy

• No use of pharmacological substances

• Mild to moderate; used in first instance
 Neurological interventions

• Electroconvulsive shock therapy (lift to level drugs can be used; memory loss problems)

• Deep brain stimulation

• Vagal nerve stimulation o Classes of antidepressants
 Typical (TCA and specific re-uptake inhibitors)

• MAOI

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