View and work a tutorial concentrating on the main classification of antidepressants. What is their main mode of action. These included the SSRI's, the SNRI's, the TCA's and the MAOI's. Discuss how each of these classes fit into the monoamine hypothesis of depression
treatment.
Outline and discuss the action of some atypical antidepressant medications, those which modulate storage of serotonin as well as inhibitors of serotonin degradation.
Review the role of serotonin and nor-epinephrine in mood control.
Discuss the action which monoamine oxidase has on the neurotransmitter molecules.
Discuss how the use of the drug imipramine blocks serotonin transport back into neuron, allowing the antidepressant action to persist.
Indicate how in 1951 a drug to treat TB was found to exhibit antidepressant activity by inhibiting monoamine oxidase enzyme, which degrades serotonin and lowers depression. Conclusions are drawn from these results, leading to an answer to the question which started the topic; major depressive disorder should be treatable with medication.
major depressive disorder and the monoamine oxidase hypothesis
Lesson Outline
Starting from where we stopped on Tues. the clinical diagnostic characteristics for diagnosis of major depressive disorder are listed, analyzed, and discussed.
The secretion of serotonin into the extracellular space along with the removal of serotonin by 5-HT transporters and degradation of 5-HT by monoamine oxidase enzyme outlined on the board. The use of the drug imipramine to block the effect of the enzyme and prolong the antidepressant affect of the serotonin elicited.
Start with a hypothesis statement: MDD should be treatable through the use of medications.
Discuss how MDD can be co-morbid.
Outline the major physiological structures for Serotonin and Norepinephrine secretion.
Discuss the large number of serotonin receptors.
Introduce the "Monoamine Hypothesis" which indicates that MDD is NOT a simple chemical imbalance but diagnostic criteria must rely on clinical evaluation.
Session Minutes
45
Minutes Student Attended
45
Lesson Comments
Nina was on line, but all notes were written on a word document.
Read a case study of patient Mary R.
Read and discuss two papers, understanding neurosis vs psychosis and the second on mood disorders.
Elicit Mary R's symptoms as being caused by bipolar depression.
Investigate the use of a lithium salt in 1949 to treat bipolar depression.
Differentiate between neurotic behavior and psychotic behavior, noting the psychological behavior of both.
List the common mood disorders affecting people, along with phobias.
Mention major depressive disorder, to be discussed in the next few classes.
Session Minutes
90
Minutes Student Attended
90
Lesson Comments
Always an interesting and mature discussion with Nina. Her questions are most insightful,
Start with a chemical and physiological description of Serotonin and norepinephrine.
Discuss the differences between neurosis and psychosis. Read and discuss the 20 common activities classed as neurosis.
Discuss the physiology of glutamate neurotransmission.
Discuss the abundance of glutamate receptors and transporters.
Outline the pathophysiology and pharmacology of glutameteergic neurotransmission, including neurodegenerative disease, stroke and trauma, epilepsy and hyperalgesia.
Outline and discuss the physiology and pharmacology of Barbiturates, their action on "GABA receptors and their widespread effect on the central nervous system.
Discuss the reticular activating system, what it controls, and the effect Barbiturates have on the system.
Discuss the effect of ethanol (alcohol) on GABA receptors along with the corresponding effect on the nervous system the mode of action for alcohol addiction.
Session Minutes
45
Minutes Student Attended
45
Lesson Comments
"Quando m'en vo" from La Boheme. (Musetta's Waltz)