NESRIs (1).pdf - PHM350 Modulators of Central Noradrenergic...

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1 PHM350 Modulators of Central Noradrenergic and Serotonergic Systems Initial Questions •What are the cellular effects of drugs which inhibit reuptake of the central nervous system transmitters norepinephrine and serotonin? •What are the behavioral effects of drugs which inhibit reuptake of the central nervous system transmitters norepinephrine and serotonin? •Are there other mechanisms to affect norepinephrine and serotonin systems to produce the same behavioral outcome? •What are the side effects of manipulating norepinephrine and serotonin systems in the central nervous system?
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2 Mood controlled by input from NE and 5HT neurons to neocortex and to limbic system NE Synapses 5HT Synapses
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3 Symptoms of Mood Change “Negative signs” of Depression •Sadness •Spontaneous crying •Hopelessness, Helplessness, Guilt •Suicidal thoughts •Apathy •Fatigue, Sleep disturbances “Positive signs” of Mania •Euphoria •Increased motivation •Inappropriate optimism •Hyperactivity Incidence of Depression 15% adults 23% female 10% male Types of Depression •Reactive Depression •Endogenous Depression •Unipolar Depression •Bipolar Disorder •Drug-induced Depression
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4 Types of Depression Reactive •Known cause - reactive to “event” •Younger people •60% all depressions •No organic problem Should not require drug intervention Will resolve when “event” is resolved Pharmacological intervention increasingly common Types of Depression Endogenous or “Major” Depression •Undetermined cause •Often no (obvious) external precipitating cause or “event” •Organic problem? CNS physical abnormality? CNS chemical abnormality? Successful pharmacological treatment suggests underlying CNS dysfunction but any dysfunction has not been demonstrated consistently
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5 Types of Depression Endogenous or “Major” Depression Unipolar Depression •85% endogenous depression •Negative signs only Bipolar Disorder •aka manic-depression •15% endogenous depression •Negative and positive signs not necessarily alternate
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  • Summer '09
  • COBBETT
  • Selective serotonin reuptake inhibitor, Antidepressant, Anti Mania Drugs, Therapeutic Anti Mania

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