This document discusses antidepressant drugs and their mechanisms of action. It begins by describing how antidepressants work by altering neurotransmitter systems like serotonin and norepinephrine in the brain. Several classes of antidepressants are then discussed, including MAOIs, TCAs, SSRIs, SNRIs, and NDRIs. Each works differently but generally aims to increase neurotransmitter activity in the brain. The document examines specific drugs in each class, their history, mechanisms, and common side effects. Mood disorders like depression and bipolar disorder are also briefly overviewed.
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
Anxiety is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat. It has several types. the presentation includes pharmacologic approach of anxiety disorder.
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
Anxiety is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat. It has several types. the presentation includes pharmacologic approach of anxiety disorder.
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
*Disclaimer
This is a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For quesitons about this blog project or its content please email the teacher Chris Jocham: jocham@fultonschools.org
Antidepressants /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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Utah Diabetes Telehealth Program --
Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)
To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html
Approximately 20% of the U.S. population and 40% of individuals with diabetes are affected by depression. Not only can depression lead to poor health outcomes, but it can also impact productivity and general quality of life.
To explore the issues surrounding depression and diabetes, Valerie Lambert, LCSW will focus on how to recognize the signs and risk factors which may indicate depression and anxiety in patients with diabetes; how to apply strategies to help someone with diabetes manage or decrease depression/anxiety and increase coping skills; and how to recognize when referral for treatment of depression/anxiety would be appropriate.
about the drugs acting on central nervous system, also their physiological effect on the brain and how Neurottransmiters in the brain response to these agents
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Unlimited Counseling CEUs for $59 https://www.allceus.com/
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CEs can be earned for this presentation at https://www.allceus.com/member/cart/index/search?q=pharmacology+of+recovery
Pinterest: drsnipes
Nurses, addiction and mental health counselors, social workers and marriage and family therapists can earn CEUs for this and other presentations at AllCEUs.com
Learn how to add certain foods and make little changes to your lifestyle to improve your mood and support recovery from physical illness, mood disorders and addictions.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Drugs that are used to relieve or prevent
psychic depression.
Work by altering the way in which specific
chemicals, called neurotransmitters, work
in our brains (i.e. in the case of
depression, some of the neurotransmitter
systems don’t seem to be working
properly).
They increase the activity of these
chemicals in our brains
3. The precise cause of affective disorders
remains elusive.
Evidence implicates alterations in the
firing patterns of a subset of biogenic
amines in the CNS, Norepinephrine (NE)
and Serotonin (5-HT).
Activity of NE and 5 -HT systems?.
4. 1950: Reserpine Induce depression
Study: Reserpine depletes storage or amine
neurotransmitters such as serotonin and
norepinephrine
Break-through: MAOI and TCA
Then: Depression Amine-dependent
synaptic transmission
(Antidepressants Amine by means of
reuptake and metabolism)
Conclusion: Major model for the subsequent
antidepressants, except Buproprion.
7. Almost all NE pathways in the brain originate from the
cell bodies of neuronal cells in the locus coereleus in
the midbrain, which send their axons diffusely to the
cortex, cerebellum and limbic areas (hippocampus,
amygdala, hypothalamus, thalamus).
Mood: -- higher functions performed by the cortex.
Cognitive function: -- function of cortex.
Drive and motivation: -- function of brainstem
Memory and emotion: -- function of the hippocampus
and amygdala.
Endocrine response: -- function of hypothalamus.
and receptors.
9. Reuptake of NE
Monoamine oxidase, located on outer membrane
of mitochondria; deaminates catecholamines free in
nerve terminal that are not protected by vesicles
Selective inhibitor,
reboxetine
Cocaine blocks the NET
Antidepressant
MAO Inhibitors
Stimulant
11. Why does a small amount of stress help you learn better?
But, too much chronic, severe stress
DEPRESSION
12.
13. As with the NE system, serotonin neurons
located in the pons and midbrain (in groups
known as raphe nuclei) send their projections
diffusely to the cortex, hippocampus,
amygdala, hypothalamus, thalamus, etc. --
same areas implicated in depression. This
system is also involve in:
• Anxiety.
• Sleep.
• Sexual behavior.
• Rhythms (Suprachiasmatic nucleus).
• Temperature regulation.
• CSF production.
17. Major depression – recurring and disabling.
Symptoms must last for at least two weeks
and impair one’s ability to interfere with a
person's ability to work, sleep, study, eat,
and enjoy once-pleasurable activities.
Chronic depression – less disabling than
major depression, but symptoms can last
longer, sometimes being unhappy for two
years. More common in women, affects 11
million people.
Atypical depression, rather than the other
two, is characterized less by pervasive
sadness and more by overeating,
oversleeping, sensitivty to rejection
18. Bipolar/manic depression oscillates between
major depression and epsidoes of mania
(extreme elation), Bipolar I – episode of
mania with or without depression. Bipolar II –
episode of depression with episode of
hypomania or mania.
Seasonal depression (SAD) – often occurs
where winters are short or there is a big
change in the amount of sunlgiht, and often
treated with light therapy.
19. persistently sad, anxious, or empty moods
loss of pleasure in usual activities (anhedonia)
feelings of helplessness, guilt, or worthlessness
crying, hopelessness, or persistent pessimism
fatigue or decreased energy
loss of memory, concentration, or decision-making capability
restlessness, irritability
sleep disturbances
change in appetite or weight
physical symptoms that defy diagnosis and do not respond to
treatment (especially pain and gastrointestinal complaints)
thoughts of suicide or death, or suicide attempts
poor self-image or self-esteem (as illustrated, for example, by
verbal self-reproach)
20. Extensive patient and family history
Blood test for hypothyroidism
Current medication
DSM-IV
One of the first two symptoms
FOUR other symptoms
29. Side effects have put MAOIs in the second or
third line of defense despite superior efficacy
MAO-A inhibitors interfere with breakdown of
tyramine
High tyramine levels cause hypertensive crisis (the
“cheese effect”)
Can be controlled with restricted diet
MAOIs interact with certain drugs
Serotonin syndrome (muscle rigidity, fever,
seizures)
Pain medications and SSRIs must be avoided
31. Imipramine was first tried as an
antipsychoti drug for schizophrenia,
proved to be insufficient but proved to
have antidepressant qualities, in the 50s
around the same time as MAOIs.
Imipramine is very good for severe
depression, but it’s almost too good – also
causes hypomania and mania
33. Side effects have made them second line of
defense to SSRIs but they are good for treatment
resistant depression bc they are so strong.
Amitriptyline – most widely used, most effectve
Desipramine – active metabolite of imipramine,
used for neuropathic pain
Doxepin – used for depression and insomnia
Imipramine – used for major depression and
enuresis
Nortriptyline – same thing
Protriptyline – depression UNIQUE BECAUSE IT IS
ENERGIZING rather than sedating
Trimipramine – depression, insomnia, and pain
34. TCAs inhibit serotonin,
norepinephrine, and
dopamine transporters,
slowing reuptake
TCAs also allow for the
downregulation of post-
synaptic receptors
All TCAs and SSRIs contain an
essential amino group that
appears to interact with Asp-
98 in hSERT
35. Muscarinic M1 receptor antagonism - anticholinergic
effects including dry mouth, blurred vision,
constipation, urinary retention and impotence
Histamine H1 receptor antagonism - sedation and
weight gain
Adrenergic α receptor antagonism - postural
hypotension
Direct membrane effects - reduced seizure threshold,
arrhythmia
Serotonin 5-HT2 receptor antagonism - weight gain
(and reduced anxiety)
36. Nonselectivity results in greater side effects
TCAs can also lead to cardiotoxicity
Increased LDH leakage
Slow cardiac conduction
High potency can lead to mania
Contraindicated with persons with bipolar disorder
or manic depression
37. Current Drugs
Mirtazapine (Remeron)
Mechanism of Action
Same as TCAs
Side Effects
38. Most commonly prescribed class
Current drugs
Mechanism of action
Side effects
Serotonin
39. Also first rationally designed drug class,
up until the 70s the antidepressants were
sort of found by accident
Serotonin is also referred to as 5-
hydroxytryptamine
41. More trade names once patent is over but I kept
original trade names
Citalopram: Major depression
Dapoxetine: Premature Ejaculation
Escitalopram: Major depression and various other
anxiety disorders
Fluxoetine: Major depression, OCD, bulimia, etc
Fluvoxamine: OCD
Paroxetine: Major depression or anxiety
Sertraline: Major depression or anxiety
Zimelidine had neurological problems like
Guillan Barre
Indalpine had problems with fetal low WBC
42. Exact mechanism remains uncertain
Ser-438 residue in the human serotonin
transporter (hSERT) appears to be a
determining factor in SSRI potency
Antidepressants interact directly with hSERT
http://www.mayoclinic.com/health/antidepre
ssants/MM00660
43. Anhedonia
Apathy
Nausea/vomiting
Drowsiness or
somnolence
Headache
Bruxism (involuntarily
grinding of the teeth)
Extremely vivid and
strange dreams
Dizziness
Fatigue
Changes in sexual
behavior
Suicidal thoughts
44. Many disappear within 4 weeks (adaption
phase)
Side effects more manageable compared to
MAOIs and TCAs
Sexual side effects are common
SSRI cessation syndrome
Brain zaps
Sexual dysfunction
45. Slightly greater efficacy than SSRIs
Slightly fewer adverse effects than SSRIs
Current drugs
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Mechanism of Action
Very similar to SSRIs
Works on both neurotransmitters
Side effects
Similar to SSRIs
Suicide
Venlafaxine 1:1
Duloxetine
46. Current drugs
Bupropion (Wellbutrin)
Mechanims of Action
Similar to SSRIs and SNRIs
More potent in inhibiting dopamine
Also anα3-β4 nicotinic antagonist
Adverse effects
Lowers seizure threshold
Suicide
Does not cause weight gain or sexual dysfunction
(even used to treat the two)
Bupropion 1:1
47. The overactive point of view
In some depressives CSF 5-HT is elevated
Approx. 30% of depressed patients do not respond to
SSRIs
Depletion of 5-HT by inhibition of tryptophan
hydroxylase (TH) alleviates depressive symptoms in
some patients
Tianeptine, a 5-HT reuptake enhancer that works
opposite to SSRIs, is a marketed antidepressant
A selective TH inhibitor shows activity in an animal
model of depression
The activation of TH by stress can be blocked by
Prozac
48.
49. Indications: depression, panic and phobias, OCD,
enuresis, anorexia nervosa, bulimia
Drug Choice: past response, tolerance to side
effects, drug-drug interactions
Treatment: 1-6 months; recent report suggests
changing if no improvement by 4 weeks
Note: All antidepressants now carry a “black
box” warning that they may lead to suicidal
thoughts/behavior
51. MANIA—too much neurotransmission?
Increased production of inositol phosphate (IP-3) which
increases intracellular Ca2+ signalling
Increased DAG which:
activates PKC which phosphorylates a number of
substrates including myristoylated alanine rich C
kinase (MARCK)
MARCK activates nuclear transcription factors and
modulates genes that increase neuromodulatory
peptide hormones and alters cell signalling which:
changes neurotransmitter synthesis
neuronal excitabiltiy
synaptic plasticity
neuronal cell loss (prefrontal cortex?)
52. a monovalent ion that can enter neurons
but is not readily removed.
major mechanism is the reduction of
neuronal PI second messenger resulting in
reduced response of neurons to ACh and
NE
may actually enhance 5-HT
53. primary therapy for mania
a narrow therapeutic window (0.8-1.2
meq/L; some guides say 0.6-1.4 meq/L)
absolutely necessary to monitor serum
level (trough level approx. 5 days after
initial dose)
solely eliminated by kidney, therefore
assess patient’s kidney function
54. tremor
decreased thyroid function
polydipsia/polyuria
edema
ECG changes (depression of T-wave)
excreted in breast milk
55. Anticonvulsants: carbamazepine and
valproic acid for rapid cyclers
Olanzepine approved for treatment of
mania
St. John’s Wort: questionable efficacy,
but high potential for drug-drug
interactions
56. Features of illness,
e.g. agitation,
hypersomia
Suicide risk
Other therapy
Other illness.
Side effects
Cost
Special problems
e.g. Age, driving,
pregnancy
57. Non compliance.
Inadequate dosage.
Other drugs e.g. alcohol, caffeine.
Unresolved outside problems.
Up to 26% failure even if above don’t apply.
58. Realm of specialists
Lithium,
carbamazepine
Mixtures i.e. SSRI
and TCA
Dangerous – need
expert supervision
59. NEUROENDOCRINE THEORY
Depression is associated with elevated
plasma cortisol level that is due to
excessive release of hypothalamic CRH.
This elevated CRH may reflect defective
monoamine transmission.
N.B hypothalamic neurons controlling
pituitary function receive noradrenergic and
serotonergic inputs which control their
discharge
60. This theory is supported by:
High CRH concentration in brain & CSF in
depressed patients
High plasma cortisol level in depressed
patients
CRH injected into brain of experimental
animals gives symptoms like that of
depression
Cushing’s syndrome is often associated with
depression
61. NEURODEGENERATION THEORY
Major depression may be associated with
neurodegeneration in the hippocampus &
prefrontal cortex and antidepressants may
act by inhibiting or actually reversing this
loss by stimulating neurogenesis
62. This theory is supported by:
Imaging studies showed shrinkage of hippocampus &
prefrontal cortex of depressed patients
Functional imaging reveals reduced neural activity in these
regions
Antidepressants promote neurogenesis in these regions and
restore functional activity
Preventing hippocampal neurogenis in depressed rats
prevents the behavioral effects of antidepressants
Antidepressants increase the production of brain derived
neurotrophic factor (BDNF) which promotes neurogenesis
and protects neurons against apoptosis