DR. ARUN KUMAR ASSOCIATE PROFESSOR SANSKAR COLLEGE OF PHARMACY AND RESEARCH, HAPUR

1. DEPRESSION

2. • Depression (major depressive disorder or clinical
depression) is a common but serious mood
disorder.
• It causes severe symptoms that affect how you
feel, think, and handle daily activities, such as
sleeping, eating, or working.
• To be diagnosed with depression, the symptoms
must be present for at least two weeks.

3. • Some forms of depression are slightly different,
or they may develop under unique
circumstances, such as:
• Persistent depressive disorder (also called
dysthymia) is a depressed mood that lasts for at
least two years.
• Postpartum depression is much more serious
than the “baby blues” (relatively mild depressive
and anxiety symptoms that typically clear within
two weeks after delivery) that many women
experience after giving birth.

4. • Psychotic depression occurs when a person has
severe depression plus some form of psychosis, such
as having disturbing false fixed beliefs (delusions) or
hearing or seeing upsetting things that others cannot
hear or see (hallucinations).
• Seasonal affective disorder is characterized by the
onset of depression during the winter months, when
there is less natural sunlight. This depression
generally lifts during spring and summer.
• Bipolar disorder is different from depression, but it is
included in this list is because someone with bipolar
disorder experiences episodes of extremely low
moods that meet the criteria for major depression
(called “bipolar depression”).

5. Signs and symptoms:
• Depressed mood
• Reduced interest or pleasure in activities previously
enjoyed, loss of sexual desire
• Unintentional weight loss (without dieting) or low appetite
• Insomnia (difficulty sleeping) or hypersomnia (excessive
sleeping)
• Psychomotor agitation, for example, restlessness
• Delayed psychomotor skills, for example, slowed
movement and speech
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Impaired ability to think, concentrate, or make decisions
• Recurrent thoughts of death or suicide, or attempt at
suicide

6. Causes
• The causes of depression are not fully
understood and may not be down to a single
source. Depression is likely to be due to a
complex combination of factors that include:
Genetics
Biological - changes in neurotransmitter levels
Environmental
Psychological and social (psychosocial)

7. • Some people are at higher risk of depression
than others; risk factors include:
• Life events: These include bereavement, divorce,
work issues, relationships with friends and family,
financial problems, medical concerns, or acute
stress.
• Personality: Those with less successful coping
strategies, or previous life trauma are more
susceptible.
• Genetic factors: Having a first-degree relatives
with depression increases the risk.
• Childhood trauma.

8. • Some prescription drugs: These include
corticosteroids, some beta-blockers, interferon,
and other prescription drugs.
• Abuse of recreational drugs: Abuse of alcohol,
amphetamines, and other drugs are strongly
linked to depression.
• A past head injury.
• Chronic pain syndromes: such as diabetes,
chronic obstructive pulmonary disease, and
cardiovascular disease make depression more
likely.

9. Treatment:
• Depression is a treatable mental illness. There are
three components to the management of
depression:
• Support, ranging from discussing practical
solutions and contributing stresses, to educating
family members.
• Psychotherapy, also known as talking therapies,
such as cognitive behavioral therapy (CBT).
• Drug treatment, specifically antidepressants.

10. • A number of classes of medication are available
in the treatment of depression such as:
Selective serotonin reuptake inhibitors (SSRIs)
Monoamine oxidase inhibitors (MAOIs)
tricyclic antidepressants
Atypical antidepressants
Selective serotonin and norepinephrine reuptake
inhibitors (SNRI)
• Exercise
• Electroconvulsive therapy

11. SCHIZOPHRENIA

12. • Schizophrenia is a mental disorder characterized
by abnormal behavior, strange speech, and a
decreased ability to understand reality.
• Other symptoms include false beliefs, unclear or
confused thinking, hearing voices that do not
exist, reduced social engagement and emotional
expression, and lack of motivation.
• People with schizophrenia often have additional
mental health problems such as anxiety,
depression, or substance-use disorders.
• Symptoms typically come on gradually, begin in
young adulthood, and, in many cases, never
resolve.

13. Signs and Symptoms:
• Symptoms of schizophrenia usually start between
ages 16 and 30. In rare cases, children have
schizophrenia too.
• The symptoms of schizophrenia fall into three
categories: positive, negative, and cognitive.
• Positive symptoms: People with positive symptoms
may “lose touch” with some aspects of reality.
Symptoms include:
Hallucinations
Delusions
Thought disorders (unusual or dysfunctional ways of
thinking)
Movement disorders (agitated body movements)

14. • Negative symptoms: “Negative” symptoms are
associated with disruptions to normal emotions
and behaviors.
• Symptoms include:
“Flat affect” (reduced expression of emotions via
facial expression or voice tone)
Reduced feelings of pleasure in everyday life
Difficulty beginning and sustaining activities
Reduced speaking

15. • Cognitive symptoms: For some patients, the
cognitive symptoms of schizophrenia are subtle,
but for others, they are more severe and patients
may notice changes in their memory or other
aspects of thinking.
• Symptoms include:
Poor “executive functioning” (the ability to
understand information and use it to make
decisions)
Trouble focusing or paying attention
Problems with “working memory” (the ability to
use information immediately after learning it)

16. Pathophysiology:
• While the mechanism of schizophrenia is
unknown, a number of attempts have been
made to explain the link between altered brain
function and schizophrenia.
• One of the most common is the dopamine
hypothesis, which attributes psychosis to the
mind's faulty interpretation of the misfiring of
dopaminergic neurons.
• Other possible mechanisms include
glutaminergic neurotransmission and
neurodevelopment.

17. Prevention and Treatment:
• Cognitive behavioral therapy (CBT): CBT is a psycho-
social intervention that aims to improve mental
health.
• CBT focuses on challenging and changing unhelpful
cognitive distortions (e.g. thoughts, beliefs, and
attitudes) and behaviors, improving emotional
regulation, and the development of personal coping
strategies that target solving current problems.
• Antipsychotic medications: Amisulpride, olanzapine,
risperidone, and clozapine.
• Psychosocial interventions: behaviour-, emotion-,
cognition- or stimulation-oriented approaches.

18. ALZHEIMER'S DISEASE (AD)

19. • Alzheimer's disease (AD), also referred to simply
as Alzheimer's, is a chronic neurodegenerative
disease that usually starts slowly and gradually
worsens over time.
• It is the cause of 60–70% of cases of dementia.
• The most common early symptom is difficulty in
remembering recent events.
• As the disease advances, symptoms can include
problems with language, disorientation, mood
swings, loss of motivation, not managing self
care, and behavioural issues.

20. • Alzheimer’s is the most common cause of dementia
among older adults.
• Dementia is the loss of cognitive functioning—
thinking, remembering, and reasoning—and
behavioral abilities to such an extent that it
interferes with a person’s daily life and activities.
• Alzheimer’s disease is named after Dr. Alois
Alzheimer. In 1906, Dr. Alzheimer noticed changes in
the brain tissue of a woman who had died of an
unusual mental illness.
• Her symptoms included memory loss, language
problems, and unpredictable behavior.
• After she died, he examined her brain and found
many abnormal clumps (amyloid plaques) and
tangled bundles of fibers (neurofibrillary, or tau,
tangles).

21. Symptoms:
• Memory loss that disrupts daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, at work
or at leisure
• Confusion with time or place
• Trouble understanding visual images and
relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace
steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality

22. Pathophysiology:
• Alzheimer's disease is characterised by loss of
neurons and synapses in the cerebral cortex and
certain subcortical regions.
• This loss results in gross atrophy of the affected
regions, including degeneration in the temporal
lobe and parietal lobe, and parts of the frontal
cortex and cingulate gyrus.

23. Prevention and Treatment:
• Avoid medication: Hypercholesterolaemia,
hypertension, diabetes, and smoking, are associated
with a higher risk of onset and course of AD.
• Manage life style: People who engage in intellectual
activities such as reading, playing board games,
completing crossword puzzles, playing musical
instruments or regular social interaction show a
reduced risk for Alzheimer's disease.
• Diet: People who maintain a healthy, Japanese, or
Mediterranean diet have a reduced risk of AD. Diet
with saturated fat and carbohydrates have a higher
risk.

24. • Medication for treatment: Five medications are
currently used to treat the cognitive problems of
AD: four are acetylcholinesterase inhibitors
(tacrine, rivastigmine, galantamine and donepezil)
and the other (memantine) is an NMDA receptor
antagonist.
• Psychosocial intervention
• Care giving