Psy 365 Exam 5 Gilbert - SDSU SPRING 2025

Reactive depression

caused by a specific event or situation, such as the loss of a loved one, a major life change, or a traumatic experience.

Major depressive episode

long-term. Some individuals do not have a reason as to why they are depressed. It's continuous; it affects your life (school, work, relationships, etc)

MAOI antidepressant

blocks the enzyme MAO, which breaks down the neurotransmitters dopamine, norepinephrine, and serotonin.

This leads to an increase in the amount of these neurotransmitters

Tricyclic Antidepressants

Blocks the reuptake of serotonin and norepinephrine

SSRIs

Blocks the reuptake of serotonin

Why are MAO-I drugs not used very much anymore?

Undesirable side affects, aversive effects when mixed with food, interacts with other medicine, not as fast as other antidepressants

Which two parts of the brain were suggested to be involved in anxiety disorders such as panic attacks and post traumatic stress disorder?

Amygdala, orbitofrontal cortex

Barbiturates

Affected by antianxiety drugs

GABA agonist (stimulates inhibition)- main mechanism of action; Glutamate antagonist (decrease excitation)

Benzodiazepines

Affected by antianxiety drugs

GABA agonist (increases function of GABA by keeping receptor open longer when bound to and slow absorption rate on own binding site)

Second generation anxiolytics

Affected by antianxiety drugs

Beta blockers, buspirone, Zolpidem

Beta blockers

block NE beta receptors

Buspirone

Agonist (stimulates 5HT-1A receptor)

Zolpidem

GABA agonist (increases function of GABA)

Dual Action Model

Anxiety is too much excitation or too little inhibition

GABA = stimulate inhibition, Glutamate = decrease excitation

What are some side effects associated with barbiturates?

-Reduces REM sleep

-Cognitive impairment

-High physical dependence and abuse

-Potentially fatal rebound effect

-High doses = gross intoxication & respiratory depression = death

-Increased liver microsomal enzymes

Which disorders are benzodiazepines used to treat?

-Anxiety

-Sleep disorders

-Muscle problems

-Mild seizures or convulsions

-Alcohol withdrawal

How is BuSpar different from other antianxiety drugs?

-Agonist for 5-HT 1A receptor

-does not target GABA

-Lower danger for addition

-Takes longer to work

-Less severe side effects

Blocks D2 (dopamine) receptors:

Thorazine and Haldol (1st generation drugs)

Blocks D4 (dopamine) receptors:

Clozaril and Seroquel (2nd generation drugs)

Blocks 5HT-2 (serotonin) receptors:

Risperdal and Zyprexa (2nd generation drugs)

1st generation drugs

thorazine, haldol

2nd generation drugs

clozaril, seroquel, zyprexa, risperdal

What is the dopamine hypothesis?

The dopamine hypothesis implies that there is dopamine overactivity in the brains of people living with schizophrenia.

Evidence against dopamine hypothesis

-Normal dopamine levels found in autopsy

-Normal levels of homovanillic acid, a DA metabolite, in the urine of people living with schizophrenia

What is the law of thirds?

⅓ of individuals respond very well, ⅓ experience no change, ⅓ will improve to some degree.

What are Parkinsonian symptoms associated with the use of first-generation antipsychotic drugs?

Parkinsonian symptoms associated with the use of first-generation antipsychotics are typically referred to as extrapyramidal symptoms

extrapyramidal symptoms

-Tardive dyskinesia (hyperkinetic movements, increased jaw movements)

-Dystonia (involuntary muscle contractions)

-Akathisia (restlessness)

What is tardive dyskinesia?

-Often found as a side effect of antipsychotic drugs, tardive dyskinesia is a condition characterized by hyperkinetic movements, such as increased, uncontrollable movements of the mouth, snapping jaw movements. It can also affect the limbs, head, or trunk

-These movements can be rapid/jerky or slow/writhing

-Can become permanent if an individual has been taking these medications for prolonged periods of time. It can also lead to other side effects such as bone marrow disease, liver disease, dry mouth, and immune system issues.

Which antipsychotic drugs treat mostly positive symptoms but have less effect on negative symptoms?

Risperidone (Risperdal) treats positive symptoms, and has less of an effect on negative symptoms

First-generation typically only treat positive symptoms

Which antipsychotic drugs treat positive and negative symptoms?

Clozaril, Risperdal, Zyprexa, Seroquel, and Abilify

What are some positive symptoms of schizophrenia?

Hallucinations, disorganized thinking or speech, disorganized motor behavior, catatonia (sit still not move), delusions

Negative symptoms of schizophrenia?

Flat affect (no emotion), low energy, poverty of speech (alogia), lack of imitative (abolition), anhedonia social withdrawal (asociality)

What is agranulocytosis?

white blood cells start to die off (it plays a role in your immune system)

What are the four basic effects of NSAIDs?

Anti-Inflammation → inflammation reliever

Antipyretic → anti-fever

Analgesia → decrease pain

Anticoagulant → blood thinner

Do all NSAIDS exert all four effects?

No

Aspirin: antipyretic, anti-inflammatory, anticoagulant and analgesic

Acetaminophen: analgesic, antipyretic, limited anti-inflammatory

Ibuprofen: analgesic, antipyretic and anti-inflammatory

(Aleve) Naproxen: anti-inflammatory

What is a risk associated with high doses of acetaminophen?

-High doses of acetaminophen are associated with liver toxicity

-Use with alcohol can cause liver failure

-Many people addicted to pain pills wind up with liver failure because certain pain pills have acetaminophen in them (e.g. Vicodin and Percocet)

Which over-the-counter chemical is often abused by adolescents to get high?

Dextromethorphan (antitussive)

Effects off dextromethorphan on the brain

antitussive drug

cough supressant

Can be fatal - blocks sweating and causes overheating in high doses

How do NSAIDs work as an analgesic (how do they reduce pain)?

-Arachidonic acid is converted into prostaglandins

-Prostaglandins: cause pain and important in the healing process

-NSAID drugs try to stop pain by blocking production of prostaglandins

-Cyclooxygenase (COX) enzyme converts arachidonic acid into prostaglandins

-NSAID blocks COX to prevent it from converting acid to prostaglandins

Who in the population should not take aspirin?

-Under 21 years of age

-With Reye's syndrome

basics of the FDA approval process.

-Pre-clinical phase: 1-3 years animal testing

-30 day safety review by FDA

-Clinical phase: human testing

Phase 1-3 lasts 7 years

-1 year review window

-phase 4: prescribe

-can all take up to 11 years

Which chemical is found in over-the-counter stimulants?

Caffeine

NOT FDA APPROVED

No test done to see side effects

No oversight

People think they are "natural" but there could be many risks

What are some of the risks discussed in class associated with the use of herbal supplements?

-There is a lack of regulation control and research

-There is no FDA approval process (they are not designed to cure or treat)

-Many supplements either don't contain what they advertise, have too much of what is labeled or could contain harmful ingredients

Which neurotransmitters are affected by ephedrine

-Norepinephrine

-Dopamine

-Serotonin

-Adrenaline (epinephrine)

Effect of ephedrine on neurotransmitters

Increased heart rate

Increased blood pressure

Similar to amphetamines in molecular structure

In 2004 ephedrine was banned as a supplement by FDA

What do companies who market ginkgo biloba claim it does?

-Claims to enhance cognition, and enhance mental sharpness

-Claims to help adults with dementia and alzheimers

(both false)

-contains antioxidants

What is St. John's wort used for in Germany?

Uses it as a prescription drug to treat insomnia, anxiety, & depression

What is St. John's wort used for in USA?

Uses it to treat mild depression; works better than placebo, but still inferior to prescription anti-depressant

Side effects of St John wort

Dry mouth

Dizziness

Constipation

Serotonin syndrome

Mild mania

Sensitivity to light

What is kava used for and what is a major concern associated with its use?

History of misinformation, advertised as being healthier than alcohol Used to relieve anxiety (stimulates GABA)

Side effects of liver damage and MAOI interactions

Unregulated and unsafe

What do companies who market echinacea claim it does?

Claims it helps with the common cold symptoms (false)

Mild allergy/GI side effects

What is Zicam used to treat?

-Suggested that it shortens the duration or lessens the symptoms of a cold

-Must be used carefully because the Zinc in zicam can cause the loss of the ability to smell

-Only available as a cough drop (aka lozenges)

What is melatonin and what is it suggested to do by companies who market it?

-Endogenous chemical produced in the pineal gland

-Synthesized from serotonin

-Marketed as a sleep-aid

-Treats jet lag and may help sleep

-Too much leads to fatigue and stomach issues

Ephedra/Ephedrine ban

banned by the FDA in 2004