Psychophamacology Ch 5

Depression

What is the most frequently presented issue in any mental health setting?

3%

What percent of the population suffers from chronic depression at any one time?

20%

What percentage of people that seek treatment take antidepressants?

Females aged 40 to 59

What gender and age group is depression more prevalent among?

Biological or endogenous depression

This form of depression is to be believed as stemming from a person, with a biological link.

Reactive or exogenous depression

This form of depression is typically caused from forces outside the body.

Alzheimer’s disease, HIV/AIDS, cancer, Parkinson’s disease

What are some diagnoses that can cause depression?

Alcohol, anti-anxiety medications, cold remedies, anti-inflammatory medications

What are some medications or substances that can worsen a patient’s depression?

80%

What percentage of depressed patients also have suicidal ideation?

Counseling and psychotherapy, medication, light therapy, exercise, Electroconvulsive therapy (ECT) therapy

What are some treatment options for patients with moderate to severe depression?

The first 16 to 20

In which sessions do clients show the greatest gains?

(TCAs) Tricyclic antidepressants

They prevent the reuptake of neurotransmitter substance back into the pre-synaptic cell.

Serotonin (5-HT), norepinephrine (NE), dopamine (D)

Which three neurotransmitters typically play a part in depression?

Clomipramine

What is the generic name for Anafranil?

Amoxapine

What is the generic name for Ascendin?

Amitriptyline

What is the generic name for Elavil?

Maprotiline

What is the generic name for Ludiomil?

Desipramine

What is the generic name for Norpramin?

Nortriptyline

What is the generic name for Pamelor, Aventyl

Doxepin

What is the generic name for Sinequan, Adapin, Silenor?

Trimpramine

What is the generic name for Surmontil?

Imipramine

What is the generic name for Tofranil?

Proptriptyline

What is the generic name for Vivactil?

Monoamine Oxidase Inhibitors (MAOIs)

They inhibit monoamine oxidase, the enzyme that breaks down neurotransmitters and renders them ineffective.

Desyrel (generic name trazodone)

This medication primarily affects serotonin but acts more as a 5-HT2 receptor antagonist.

Selective serotonin reuptake inhibitors (SSRIs)

They block the reuptake of serotonin back into the presynaptic cell.

Selegiline transdermal system

What is the generic name for ENSAM?

Isocarboxazid

What is the generic name for Marplan?

Phenelzine

What is the generic name for Nardil?

Tranylcypromine

What is the generic name for Parnate?

Citalopram

What is the generic name for Celexa?

Escitalopram

What is the generic name for Lexapro?

Fluvoxamine

What is the generic name for Luvox?

Paroxetine

What is the generic name for Paxil, Paxil CR, Pexeva?

Fluoxetine

What is the generic name for Prozac, Sarafem

Sertraline

What is the generic name for Zoloft?

Serotonin syndrome

Occurs when serotonin levels inside the central nervous system become too elevated from using SSRIs.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

It predominantly potentiates norepinephrine over serotonin.

Duloxetine

What is the generic name for Cymbalta?

Venlafaxine (XR)

What is the generic name for Effexor (XR)?

Levomilnacipran

What is the generic name for Fetzima?

Desvenlafaxine

What is the generic name for Pristiq

Bupropion hydrobromide

What is the generic name for Aplenzin?

Trazodone

What is the generic name for Desyrel, Oleptro?

Mirtazapine

What is the generic name for Remeron (Soltab)?

Nefazodone

What is the generic name for Serzone?

Vortioxetine

What is the generic name for Trintellix?

Vilazodone

What is the generic name for Viibyrd?

Bupropion (SR) or (XL)

What is the generic name for Wellbutrin (SR) or (XL)?

Atypical antidepressants

They may have similar side effects to antidepressants, but they have less possibility of sexual dysfunction.

Lithium

What is a possible treatment option for unipolar or bipolar depression?

Hypercin

What is the active ingredient in St. John’s wort plant?

St. John’s wort

According to research conducted in Europe, which plant is claimed to control mild to moderate depression with little side effects?

Ginkgo biloba

A tree of Chinese origin, said to relieve mild depression and increase memory and concentration.

Dehydroepiandrosterone (DHEA)

Secreted by the adrenal gland and is a persecutor to testosterone and estrogen.

S-adenosyl-L-methionine (SAM-e)

A distance that is endogenous to the body, that is essential to many biological processes, such as cell methylation.

Zinc, magnesium, lavender, saffron, omega 3-fatty acids

What are some substances that may possess antidepressant properties?

Light therapy

Used for patients experiencing seasonal depression that live in colder, darker climates.

It helps to release important endorphins and neuromodulators such as phenylethylamine (PEA).

What are some benefits of exercise for depressed patients?

Electroconvulsive therapy (ECT)

Given when the patient is anesthetized and paralyzed. Electricity is administered to cause a seizure.

Start with easier medications first, such as SSRIs with a low dose.

What is step 1 of the treatment protocol?

If a patient has only a partial response to SSRIs, the clinician can add additional medications aimed at other neurotransmitters.

What is step 2 of the treatment protocol?

If the patient appears to have psychotic features in addition to depression, an appropriate neuroleptic or antipsychotic medication might need to be added.

What is step 3 of the treatment protocol?

If there is still no response, the clinician should check with the patient to determine if they are correctly adhering to the medication regimen.

What is step 4 of the treatment protocol?

The therapist should keep in mind that certain medications are contradicted for certain types of patients.

What is step 5 of the treatment protocol?

Antidepressants take time to work, inform them of the types of side effects, medications should not be stopped abruptly, antidepressants should not be taken by pregnant patients unless necessary, antidepressants typically relieve symptoms of depression and associated anxiety.

What are the five acts that a therapist should inform a patient of?

Dry mouth, inability to reach orgasm, forgetfulness, insomnia, sedation, weight gain, stomach upset, headache and hand tremors

What are common side effects with medication?