Depression and bipolar disorder - Anti-depressants

9 important questions on Depression and bipolar disorder - Anti-depressants

Which types of drugs do we have for depression?

  • MAOI (prevents breakdown)
  • TCA (not selective inhibitors of re-uptake)
  • SSRI (selective)

How do Tricyclic antidepressants work?

Prevents re-uptake NA and 5HT
One more selective for one then the other.

What is typical about the TCA's and SSRI?

Late onset.
Autoreceptors do their job 5HT1D.
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What is the transporter called where the working of the SSRIs is based on? And what is the effect?

SERT.
They bind to this

Preventing degradation + reuptake

What are adverse effects of SSRIs?

Nausea
Sexual side-effects
Suicidal thinking
  

TCAs are not selective. Which receptors do they target more?

  • Histamine => drowsiness
  • Acetylcholine mus =>.

What are chronic effects of anti-depressants?

  • SSRI: Desensitize inhibitory autoreceptors (A, D)
  • TCA and ECT: sensitize 5HT1A, less expression of 5HT2A
  • Effect post-receptor mechanims => G-coupled proteins

How does Ketamine work?

It is a NMDA (glutamate) on a GABA neuron antagonist.

NMDA antagonist => AMPA => mTOR => protein translation => synaptic plasticity.

What are the mechanisms of actions of lithium?

  • Mimic Na+
  • Blocks the PI (PIP2, InsP3/DAG etc) pathway

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