Dementia and Depression

What NTs + their uses are involved in Alzheimer’s?

Acetylcholine: sensory processing/attention/memory

Glutamate: learning/memory/processing - enhances electrical flow

What are the therapeutic goals of treating Alzheimer’s?

Increase ACh and decrease Glutamate

Memantine/Namenda

Treats Alzheimer’s by decreasing Glutamate: NMDA glutamate receptor antagonist

Donepezil/Aricept

Treats Alzheimer’s by increasing ACh: AChE inhibitor 

What is the monoamine hypothesis for how depression works?

Monoamines are dopamine, serotonin, and NE. Less of these NTs are present in people with depression because there are a lot of MAOs breaking them down 

What are the 3 main mechanisms of action for antidepressants?

Block transmitter reuptake, inhibit presynaptic autoreceptors which reduce NT release, or inhibit MAOs which break down NTs

Describe TCAs and give 2 examples

Tricyclic antidepressants block NT reuptake- nonspecific and very strong

Amitriptyline and Nortriptyline

What are SEs of TCAs and tetracyclines?

Dry mouth, blurred vision, constipation, sedation, weight gain, postural hypotension, reduced seizure thresholds, arrythmia, delirium, psychosis

Describe tetracyclics and give an example

Non-selective antidepressant that blocks presynaptic autoreceptors - Mirtazapine

Describe SSRIs and give 5 examples

Block transmitter reuptake but more specific than TCAs (serotonin only)

Fluoxetine, sertraline, citalopram, paroxetine, escitalopram

What are SEs of SSRIs?

Early onset: nausea, anxiety, agitation

Late onset: weight gain, weakness, sexual dysfunction

Describe SNRIs and give 3 examples

Block transmitter reuptake, used to treat depression, anxiety disorders, and chronic nerve pain

Venlafaxine, duloxetine, desvenlafaxine 

What are SEs of SNRIs?

Dry mouth, insomnia, blurred vision, HTN, seizures (Duloxetine)