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DEPRESSION: Video: Biol. Blues

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

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  1. 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

  2. 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).

  3. RECEPTOR REGULATION UP NORMAL DOWN

  4. 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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