This document summarizes information about affective disorders including major depressive disorder and bipolar disorder. It discusses the role of serotonin in major depressive disorder and the use of tryptophan supplements to elevate serotonin levels. Symptoms of major depressive disorder are outlined. The heritability and biosynthetic pathway of serotonin are also summarized. Information is provided about various antidepressant medications including their mechanisms of action, efficacy, side effects and prevalence of use. Electroconvulsive therapy and cognitive behavioral therapy are discussed as treatments for depression. Diagnosis and treatment of bipolar disorder including the use of lithium is also summarized briefly.
lecture 13 from a college level introduction to psychology course taught Fall 2011 by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University, includes DSM-IV TR criteria for major depression and bipolar I & II, serotonin, learned helplessness
This presentation provides all the relevant information about mental depression and anti-depressants. It will be useful to students of medicine, pharmacology, pharmacy, and pharmaceutical industry.
lecture 13 from a college level introduction to psychology course taught Fall 2011 by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University, includes DSM-IV TR criteria for major depression and bipolar I & II, serotonin, learned helplessness
This presentation provides all the relevant information about mental depression and anti-depressants. It will be useful to students of medicine, pharmacology, pharmacy, and pharmaceutical industry.
Lecture 21 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Focus is on DSM IV TR criteria for anxiety disorders and their pharmacological treatments.
This presentation deals with the various medicines used in the treatment of depression and mania. The drugs used include MAO inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibtors and atypical antidepressants with a brief mention of Lithium at the end
Depression is a psychological state of mind. It is a major problem faced by most of the people especially the youths. all the reasons why depression is caused what are it's symptoms signs how must the person be treated is explained in this slide
Lecture 21 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Focus is on DSM IV TR criteria for anxiety disorders and their pharmacological treatments.
This presentation deals with the various medicines used in the treatment of depression and mania. The drugs used include MAO inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibtors and atypical antidepressants with a brief mention of Lithium at the end
Depression is a psychological state of mind. It is a major problem faced by most of the people especially the youths. all the reasons why depression is caused what are it's symptoms signs how must the person be treated is explained in this slide
Lecture 22 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Focus is on typical and atypical antipsychotics.
Current recreational drugs: RX462 Drug Abuse & Society, Spring 2015 Class pre...Brian Piper
These are the presentations from 2nd and 3rd year pharmacy students from semester long projects on a recreational drug of their choosing. Each presentations contains what was currently known (as of spring, 2015) about the history, epidemiology, pharmacokinetics, and pharmacodynamics of a recreational drug of their choosing.
Contents :
Amyloid
Apoprotein
Arthritis
Avascular necrosis
Bone graft
Brain
Bronchogenic carcinoma
Census
Clotting factors
Contraception
Inflammatory bowel disease
Cerebrospinal fluid
Culture media
Dementia
Electroencephalogram
Engaging diameter
Estrogen
Familial hyperlipoproteinemia
Features of fibroid
Firearm
Gastric motility
Absorption in gut and nephron
Hormones
Hypersensitivity
Immunoglobulin
Inborn errors of metabolism and deficient enzymes
Kidney stones
Lithium
Lung volumes and capacities
Metabolic acidosis
Mosquito
Nerve fibers
Muscles and nerve supply
Changes in pregnancy
Methods for proteins
Protooncogenes and tumor suppressor genes
Radioisotopes
Rickettsial zoonoses
Root values for reflexes
Rapidly progressing glomerulonephritis
Small intestinal biopsy
Specimen preservation in poisoning
Sexually transmitted diseases
Sterilization and disinfection
Tetanus
Toxins in food
Management of poisoning
Vaccination
Vaginal cytology
Vitamins
For more details, visit www.medpgnotes.com
You can send your queries to medpgnotes@gmail.com
Contents :
Age group for diseases
Dentition
Developmental milestones
Gestational weeks
Important days
Important duration
Important years
Infectious diseases and incubation period
Paranasal sinuses
Period of communicability
Primitive reflexes
Psychosexual stages of development
Other important timelines
Best time for surgery
Trimesters
For more details, visit www.medpgnotes.com
You can send your queries to medpgnotes@gmail.com
Contents :
Anticholinesterase
Autacoids
Beta blockers
Bisphosphonates
Cataract nuggets
Condition and specific drug
Condition and specific surgery
Diabetes nuggets
Different usage of drugs
Drug of choice
Drug kinetics
Few drug interactions
Mechanism of action of drugs
Monoclonal antibodies
Nitrates nugget
Opioid nugget
Prodrugs
Safest drugs in pregnancy nugget
Steroid drugs
Treatment of choice
For more details, visit www.medpgnotes.com
You can send your queries to medpgnotes@gmail.com
Contents :
Sensitive and specific antibodies
Specific calcification
Cast / brace/ splint
Enzymes of mitochondria and cytosol
Human leucocyte antigen
Inhibitors in biochemistry
Types of joints
Longest and shortest acting drugs
Male and female analogue
Male and female preponderance
Mode of inheritance
Named fractures
Important tables in nutrition chapter
Specific names in orthopedics
Rate limiting enzymes
Physiology of receptors
Right and left laterality
Sensitive and resistive to radiation
Sensitive and specific investigation
Condition and specific terms
Names of staging/grading/prognostic system
Surgery names
Tumor marker
Vectors
X ray views
Important lists
Important tables in anesthesiology
Important tables in dermatology
Important tables in embryology
Clarke’s grouping of heart diseases in pregnancy
Forrest classification
Classification of leprosy
For more details, visit www.medpgnotes.com
You can send your queries to medpgnotes@gmail.com
Contents :
Most commons
Most common type
Most common cause
Most common form
Most common lesion
Most common complication
Most common Joint
Most common indication
Most common manifestation
Most common mode
Most common nerve
Most common side effect
Most common presentation
Most common site
Most common tumor
This is an overview of drugs used to treat migraine with an emphasis on serotonergic drugs. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46. A bit of general background on 5-HT is also included.
lecture 28 from a college level introduction to psychology course taught Fall 2011 by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University, includes drugs, electroconvulsive therapy
This presentation was delivered over two days to second year pharmacy students enrolled in a course in pharmacology & toxicology. This lecture is designed to accompany Goodman & Gilman's (12e) chapter 11.
Pharmacotherapies for parkinsons diseaseBrian Piper
This seminar was delivered to 2nd year pharmacy students as part of 2 lectures for a pharmacology & toxicology class. This material accompanies Goodman & Gilman's (12e) chapter 22.
Lecture 23 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Includes epidemiology, pharmacokinetics, of pharmacodynamics of LSD, ketamine, PCP, and peyote.
Lecture 4 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Includes hypericum, melatonin, ginsing, serotonin
2 & 3 together hormones, allopathic psychiatryLouis Cady, MD
Dr. Cady's update lecture for World Link Medical - August 17, 2012. Topics: use of hormones in functional medicine (and psychiatry) as well as "pedal to the metal" allopathic psychiatry.
Drug Abuse & Society (RX 462) Presentations-Spring 2014Brian Piper
This includes end of the semester presentations made by 2nd and 3rd year pharmacy students as part of an elective course. Each student was asked to provide information about history, epidemiology, pharmacodynamics, pharmacokinetics, and toxicology. Older "classic" (psilocybin, ayahuasca, crack), newer (JWB-018, mephedrone, MDA) drugs were covered as well as agents that have appreciable use outside the U.S. (desomorphine, areca nut, kava).
Overview of electronic cigarettes including history, components, safety and adverse events, efficacy in smoking cessation, pharmacokinetics and epidemiology. This presentation was originally delivered to 2nd year pharmacy students as part of a two semester class on pharmacology and toxicology.
Examination of Sexually Dimorphic Behavior on the Novel-Image Novel-Location ...Brian Piper
Objectives: Sex differences in object location memory favoring females appear to be a replicable phenomenon but may also depend on the task demands. This investigation evaluated if females outperformed males at both a short (immediate) and long (half-hour) interval between the learn and test condition using a recently developed version of the Novel-Image Novel-Location (NINL) test (Piper et al. 2011, Physiology & Behavior,
103, 513 - 522). Methods: Young-adults (N = 184) completed a standardized handedness inventory and the NINL. Results: Participants assigned to the Immediate and Delayed conditions did not differ in age, sex, or handedness. The NINL total score was higher among females at the Immediate, but not Delayed, interval. However, within the Delayed condition, females excelled at correctly identifying the unchanged items with a similar pattern for the Novel-Location (NL) scale. Conclusions: These findings are consistent with the view that sexually dimorphic performance favoring females in neurocognitive function can also extend to tasks that have a spatial component.
Drug abuse and society drug presentations: Spring 2013Brian Piper
This presentation is on recreational drugs as part of a elective course for 2nd and 3rd year pharmacy students. The instructions were to include what is known about history, pharmacodynamics, pharmacokinetics including common routes of administration, overdose potential, and recent epidemiology.
The class chose some older agents (peyote, LSD, mushrooms, cocaine), others that have only become more popular recently (bath sats, synthetic cannabinoids), and some medical drugs (methylphenidate, oxycontin).
Pharmacotherapies for neurodegenerative disordersBrian Piper
This seminar was presented to 2nd year pharmacy students enrolled in a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 22.
This is an overview of drugs used to control nausea and vomiting. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
3. Major Depressive Disorder
• Five + (1 or 2) causing significant social or
occupational impairment not due to medical
condition
– 1) Depressed mood most of the day, nearly every day
– 2) Marked diminished interest or pleasure, in activities
– 3) Significant weight loss/gain (+5%/month)
– 4) Insomnia/hypersomnia
– 5) Fatigue or loss of energy
– 6) Diminished ability to think or concentrate
– 7) recurrent thoughts of death, suicidal attempt/plan
Anna M. Kring, Ph.D. Lecture 14, 19:38-23:08
4. Edvard Munch (1863-1944) Vincent van Gogh (1853-1890)
Despair (1894) Sorrowing Old Man (‘At Eternity’s Gate’)
1890
5. MDD
• Episode = 6 months
• Female: Males (2:1)
• Age of Onset (younger)
10. Role of 5-HT in MDD
• Methods: 15 un-medicated women with a
history of 2+ episodes of depression were on a
low protein diet for 1 week, then randomly
assigned to receive:
– Tryptophan + : L-tryptophan (1.9 g), L-alanine (4.6
g) L-arginine (4.1 g)
– Tryptophan - : L-alanine (4.6 g) L-arginine (4.1 g)
21. Fenfluramine
• Fenfluramine is a 5-HT releaser that was used
with phentermine for weight control
• Animal studies indicate fenfluramine causes 5-HT
axotomy
• Methods: Former fenfluramine users (N=15) and
controls (N=17) completed PET imaging
McCann et al. (2007). Molecular Imaging & Biology, 9, 151-157.
23. 5-HT1A Agonist: 8-OH-DPAT
• Example#1: Rats received MDMA from age 35 to 60
• A 8-OH-DPAT (8-hydroxy-2-(di-n-propylamino)tetralin)
challenge was administered at age 67
Piper et al. (2006) JPET, 317, 838-849.
24. 5-HT2A Agonist:
DOI
• Example #2: Rats received
MDMA from age 35 to 60
• A DOI (di-methoxy-4-iodophenyl)-
2-aminopropane) challenge was
administered at age 67
Biezonski et al. (2009) Brain Research, 1252, 87-93.
26. MAO-Is
• Monoamine Oxidase (MAO) is an enzyme that
breaks down 5-HT, NE, & DA; peak use in
1970s
• Food Interactions:
– Tyramine: amino acid breakdown product of
tyrosine, doesn’t cross BBB but causes
norepinephrine release
– Tyramine rich foods (aged cheese, beer, wine) +
MAO-I results in increased blood pressure &
headaches (“cheese effect”)
27. MAO-Is
• Monoamine Oxidase (MAO) is an enzyme that
breaks down 5-HT, NE, & DA
• Food Interactions: tyramine foods (aged cheese, beer,
wine) results in increased norepinephrine (blood pressure)
• Drug Interactions: increased activity of drugs that elevated 5-
HT, NE, DA (cocaine, hypericum, ritalin)
• 1st generation were irreversible inhibitors
(1960s), 2nd generation are reversible
inhibitors
30. Serotonin Reuptake Inhibitors
• Prozac (fluoxetine) was the original SRI
• Greater affinity for SERT than NET
• Not Selective (sigma receptors, CYP2D6)
• Anorgasmia
31. Comparison
MAO-Is TCA SSRIs
Efficacy Moderate Moderate Low
Side-effects “cheese effect”, orthostatic Sexual,
many drug hypertension, OD Discontinuation
interactions Syndrome
Prevalence very low low high
Mechanism 5-HT, NE, DA 5-HT & NE 5-HT
Therapeutic Lag Yes Yes Yes
32. Other Mechanisms of Antidepressants
• 5-HT2
• Intracellelar (e.g. cAMP)
• Brain Derived Neurotrophic Factor
33. Cortisol
• The Hypothalamus-Pituitary-Adrenal (HPA) axis
control release of the stress hormone cortisol.
• As many as half of depressed patients show
elevations in cortisol. Drugs that turn off the HPA axis
are ineffective.
Belmaker & Agam (2008). New England Journal of Medicine, 358, 55-68.
34. Structural Changes following Elevated
Cortisol?
• Rat research indicate that persistent increases in cortisol are toxic to hippocampal
neurons.
• Studies examining the volume of the hippocampus in MDD were inconsistent.
• A meta-analysis showed that the left (-4.5%) and right hippocampus (-4.0%)
showed reductions.
Cole et al. (2011). J of Affective Dis 134, 483-487.
35. Antidepressants &
Neurogenesis
• New neurons are produced in the
hippocampus in adults
ECS: electroconvulsive therapy; TCP: trancyclpromine (MAO-I), or Reboxetine (SNRI)
Mahlberg (2000). J Neurosciece, 20, 9104-9110.
36. Electroconvulsive Therapy
• The most effective treatment for MDD (especially high
suicide risk)
• Controversial!
• Potential memory loss
• George, David T. (2011). Electroconvulsive therapy. Starts at
54:50: http://videocast.nih.gov/Summary.asp?File=16674
37. Cognitive Behavioral Therapy
• Short, evidence based, therapy
• Developed by Aaron T. Beck
• Instruction in how thoughts & feelings
influence behavior
1921-
38. CBT + Medication
• Patients randomized to receive Nefazodone (5-
HT2A/1 antagonist), CBT, or both for 3 months
Nef CBT Nef +CBT
Completers 69.5% 72.2% 76.5%
No Response
44% 48% 15%
Remission 22% 24% 42%
Keller et al (2000). New England J of
Medicine, 342, 1462-1470.
39. Diagnosis of Bipolar
• Bipolar I: • Bipolar II:
– manic episode – Hypomanic Episode
– depression not – major depressive episode
required – not due to recreational
– not due to drugs
recreational drugs
40. Example of Mania
• Lifetime prevalence: 1%
• 1st Minute:
http://www.youtube.com/watch?v=rcl09ztmo
Dw
41. National trends in visits with a diagnosis of bipolar disorder as a percentage of total office-based
visits by youth (aged 0-19 years) and adults (aged >= 20 years)
Moreno, C. et al. (2007). Arch Gen Psychiatry, 64, 1032-1039.
42. Bipolar Disorder
Many great writers, poets, and composers
suffered from bipolar disorder. During their
manic phase creativity surged, but not during
their depressed phase.
George C. Beresford/ Hulton Getty Pictures Library
Earl Theissen/ Hulton Getty Pictures Library
The Granger Collection
Bettmann/ Corbis
Whitman Wolfe Clemens Hemingway
43. Treatment
• Lithium carbonate (Li2CO3)
• John Cade, Australian psychiatrist, on giving
lithium to guinea pigs:
– “After a latent period of about two-hours, the animals, although fully conscious
became extremely lethargic and unresponsive to stimuli for one to two hours before
once again becoming timid and active. Those who have experimented with guinea
pigs know to what extent a ready startle reaction is part of their makeup. It was even
more startling to find that after the injection of a solution of lithium carbonate they
could be turned on their backs and that, instead of the usual frantic righting
behavior, they merely lay there and gazed placidly back at him.”
44. Depression & Pregnancy
• Drug treatment &
pregnancy is a tough
decision.
• Depression may also
occur Post-partum.
Payne, Jenifer L. (2011). Clinical care of Major Depression during
pregnancy. Starts at 31:20: http://videocast.nih.gov/Summary.asp?File=16674