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DEPRESSION: Video: Biol. Blues Reactive; endogenous; bi- or unipolar, dysthymic Heredity--monozygotic ~70%; dizygotic ~15%(diathesis-stress) PET-- amygdala, prefrontal cortex, anterior cingulate cortex Neuropharmacology:

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DEPRESSION: Video: Biol. Blues

Reactive; endogenous; bi- or unipolar, dysthymic

Heredity--monozygotic ~70%; dizygotic ~15%(diathesis-stress)

PET-- amygdala, prefrontal cortex, anterior cingulate cortex

Neuropharmacology:

Monoamine oxydase inhibitors (MAOI)

Tricyclics

Lithium– G-protein, cAMP, metabotropic receptor

Monoamine Hypothesis (1960s)

Amine Receptor Hyp. (1990s):

1. Supersensitive beta-NE

2. Subsensitive postsynaptic 5-HT and/or supersensitive

presynaptic autoreceptors

Anti-depressants:

a. MAOI, Tricyclics: NE in synapse--beta NE receptors

b. 5-HT Reuptake Inhib (Prozac): presyn. Autorec. and/or

postsyn. 5-HT 1A Receptors .

c. New combination: beta NE + 5-HT autorec. + postsyn. rec


5-HT Reuptake Inhib. (SSRI, eg., Prozac):

1. 5-HT in synapse up

2. Down-regulate presynaptic autoreceptors

-- negative feedback down

-- presynaptic release of 5-HT up

3. Synaptic 5-HT up

-- a. reuptake block (Prozac)

-- b. presynaptic release up

-- stimulation of subsensitive postsynaptic 5-HT-1A

‘normalized’ (PET: 5-HT 1A reduced in raphe n.

and cingulate).


RECEPTOR REGULATION

UP

NORMAL

DOWN


Circadian rhythms:

REM, SWS, ECT

PET: amygdala, prefrontal cortex, anterior cingulate cortex

Volume: amygdala larger, hippocampus smaller

Neurotrophic Factors

rumination

oxytocin


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