nancy long sieber, ph.d. sept. 13, 2010 a bit about lupus and then neuropathophysiology i
Post on 21-Dec-2015
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The arrow labeled "axon" is pointing directly at the initial segment.
http://medlibrary.org/medwiki/Axon_hillock
EPSPs and IPSPs are integrated at a site at the base of the axon called the initial segment
(also known as the axon hillock).
Depression
http://www.drugdevelopment-technology.com/projects/rasagiline/rasagiline1.html
Drugs that treat depression• Monoamine oxidase inhibitors (MAOIs) – block the enzyme that breaks
down norepinephrine and serotonin
• Selective serotonin reuptake inhibitors (SSRIs) – block reuptake of serotonin by the presynaptic neuron. Eg: Prozac
• Serotonin-Norepinephrine reuptake inhibitors – block reuptake of both serotonin and norepinephrine. Some also block dopamine reuptake. Eg: Wellbutrin
•
While studying modern antidepressant drugs, researchers identified a treatment
that worked 75% as well as the drugs under consideration, with no side effects.
The placebo effect is greatest on conditions that respond to the body’s own biochemicals, such as
endogenous opioids and dopamine.
Placebos sometimes work for:
• Hypertension • Pain • Parkinson’s disease • Psoriasis • Rheumatoid arthritis • Ulcers
Placebos do not work for:
• Atherosclerosis • Cancer • Growth-hormone deficiency • High cholesterol • Infertility • Obsessive-compulsive disorder
Newsweek 2/8/10 Sharon Begley “The Placebo Effect”
Current thoughts on antidepressants
• Antidepressants appear to be most effective for severe depression and chronic mild depression
• In mild to moderate depression, it is difficult to distinguish between drug effect and placebo effect.
• Drugs work best when combined with psychotherapy.
Bipolar Disorder
Characterized by over activity of the amygdala and under activity of the prefrontal cortex
http://cwx.prenhall.com/bookbind/pubbooks/morris5/medialib/images/F02_09.jpg
Diagnosed with bipolar disorder and attention deficit disorder at age 2.
Died at age 4 of an overdose of prescription drugs used to treat these conditions.
Is it better to diagnose and treat these conditions early, or is the risk of over-diagnosing and over-treating too great?
How can we assure that parents don’t misuse these powerful drugs?
Rebecca Riley
How common is bipolar in children?
Dopamine
• Parkinson’s disease is associated with a loss of dopamine-producing neurons in the basal ganglia, which is involved in movement.
• Schizophrenia is associated with an excess of dopaminergic transmission.
Dopamine also helps regulate mood.
• Central to our feeling of pleasure and reward.
• Dopamine is also associated with motivation and memory.
• Addictive drugs and behaviors involve dopamine pathways.
Drugs and Dopamine• All addictions are thought to involve dopamine – it
provides the drive to repeat pleasurable behaviors eg: smoking, drinking, shopping, etc.
• Some drugs directly alter dopamine neurotransmission– Methamphetamine causes the release of large amounts of
dopamine– Cocaine blocks reuptake of dopamine at the synapse
Methamphetamine use affects the entire body
http://factoidz.com/methamphetamine-and-the-damage-it-does/
Cocaine blocks dopamine reuptake – results in feelings of euphoria
http://www.nida.nih.gov/NIDA_Notes/NNVol13N2/brain.gif
Dopamine and Addiction
Dopamine is made in the ventral tegmental area (VTA), and is released in the nucleus accumbens, the pleasure center.
Methamphetamine use causes permanent damage to the brain
http://www.nida.nih.gov/NIDA_Notes/NNVol15N4/Methamphetamine.html
How to treat addiction?• Detoxification – safely withdraw from drug
• Rehabilitation – slow process of dealing with psychological as well as physical addiction
• Medications used:– Safer forms of drugs that act on the same receptors
as the drug of abuse. Eg: nicotine patch, methadone– Drugs that block the effect of drug, or that cause
illness if drug is used. Eg: Antabuse for alcohol.– Certain antidepressants also help. Eg: Wellbutrin
Alcohol Consumption Per Capita
How to treat addiction?
• Detoxification – safely withdraw from drug
• Rehabilitation – slow process of dealing with psychological as well as physical addiction.
• Medications used:– Safer forms of drugs that act on the same receptors
as the drug of abuse. Eg: nicotine patch, methadone– Drugs that block the effect of drug, or that cause
illness if drug is used. Eg: Antabuse for alcohol.– Certain antidepressants also help. Eg: Wellbutrin
Major Neurotransmitters
Small MoleculesNeuropeptides
AcetylcholineNitric OxideBiogenic AminesEpinephrineNorepineprineDopamineSerotoninHistamineAmino AcidsGlutamateAminobutyric Acid (GABA)GlycineAspartateHomocysteineTaurineNucleotidesAdenosineAdenosine triphosphate
Hypothalamic Releasing HormonesCorticotrophic Releasing Hormone
Growth Hormone Releasing HormoneThyrotrophin Releasing Hormone
Pituitary Peptidesß endorphins
OxytoxinVasopressin
Adrenocorticotropic Hormone (ACTH)Thyroid Stimulating Hormone (TSH)
Growth HormoneGastrointestinal Peptides
SecretinSubstance P
InsulinGastrin
NeurotensinSomatostatin
CholecystokininOthers
AngiotensinBradykinin
Neuropeptide YCalcitonin