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inthewards:

 Anti-depressants

Tricyclic Anti-Depressants (TCA)

a.         Imipramine (Tofranil)

b.         Amitriptyline (Elavil)

c.          Trimipramine (Surmontil)

Side Effects – sedation, orthostatic hypotension, tachycardia, arrhythmia, dry mouth, constipation blurred vision, weight gain


Monoamine Oxidase Inhibitors (MAOi)

a.         Phenelzine (Nardil)

b.         Tranylcypromine (Parnate)

Side Effects – orthostatic hypotension, drowsiness, weight gain, sexual dysfunction, dry mouth


Selective Serotonin Reuptake Inhibitors (SSRI)

a.         Fluoxetine (Prozac)

b.         Fluvoxamine (Luvox)

c.          Escitalopram (Lexapro)

Side Effects – Sexual dysfunction, GI disturbance, Insomnia, headache, anorexia, weight loss, serotonin syndrome when used with MAOi

Atypical Anti-Depressants

a.         SNRI

Disorders treated:

1.         Obsessive compulsive disorder

2.         Panic disorder

3.         Eating disorder

4.         Dysthymia

5.         Social phobia

6.         Post traumatic stress disorder

7.         Irritable bowel syndrome

8.         Enuresis

9.         Neuropathic pain

10.       Migraine headaches

11.       Smoking cessation

12.       Autism

13.       Premenstrual dysphoric disorder

14.       Depressive phase of manic depression

15.       Insomnia

Anti-psychotics

Typical (blocks dopamine receptors)

1.         Chlorpromazine (Thorazine) – low potency

2.         Haloperidol (Haldol) – high potency

Side Effects – extrapyramidal side effects (parkinsonism, akathisia, dystonia), hyperprolactinemia

Atypical (blocks dopamine and serotonin receptors) lesser side effects

1.         Risperidone (Risperdal)

2.         Clozapine (Clozaril)

Side Effects – Anti-HAM effects (anti-histaminic, anti-adrenergic, anti-muscarinic)

 

Mood Stabilizers

Acute management and to help prevent relapses of manic episodes

Lithium

Tx of acute mania and prophylaxis for both manic and depressive episodes in bipolar disorder

Side Effects – fine tremor, sedation, ataxia, thirst, weight gain, GI problems, hypothyroidism, thyroid enlargement, nephrogenic diabetic insipidus

Therapeutic range (0.7 – 1.2), Toxic >1.5 Lethal >2


Carbamazepine (Tegretol)

a.         Anti-convulsant

b.         Tx mixed episodes and rapid cycling bipolar disorder, management of trigeminal neuralgia

c.          Inhibits sodium channels, onset 5 – 7 days

Side Effects – skin rash, drowsiness, ataxia, slurred speech, leucopenia, hyponatremia, aplastic anaemia, agranulocytosis

e.         Elevates liver enzymes, teratogenic in pregnancy


Valproic Acid (Depakene)

a.         Anti-convulsant

b.         Tx mixed manic episodes and rapid cycling bipolar disorder

c.          Increases CNS GABA

Side Effects – sedation, weight gain, alopecia, haemorrhagic pancreatitis, hepatotoxicity, thrombocytopenia

e.         Teratogenic in pregnancy

Anxiolytics / Hypnotics

Diffusely depressing CNS causing sedative effect

Common Indications

1.         Anxiety disorders

2.         Muscle spasm

3.         Seizures

4.         Sleep disorders

5.         Alcohol withdrawal

6.         Anesthesia induction


Benzodiazepines

1.         First line anxiolytics – safety at high doses

2.         Potential for tolerance and dependence after prolonged use

3.         Potentiates the effects of GABA

Long acting (1-3 days)

a.         Diazepam (Valium) – rapid onset, anxiety + seizure control

b.         Chlordiazepoxide (Librium) – alcohol detoxification, pre surgery anxiety


Intermediate acting (10 – 20 hours)

a.         Alprazolam (Xanax) – txt of panic attacks

b.         Lorazepam (Ativan) – txt of panic attacks, alcohol withdrawal


Short acting (3 – 8 hours)

a.         Oxazepam (Serax)

b.         Triazolam (Halcion) – tx of insomnia


Side Effects – drowsiness, impairment of intellectual function, reduced motor coordination, respiratory depression in overdose (esp when combined with alcohol)


Others:

Zolpidem (Ambien)/Zaleplon (Sonata)

Buspirone (BuSpar) – alternative to BDZ – low potential for abuse/addiction

Propranolol – beta blocker in tx of autonomic effects of panic attack (tachycardia, palpitations, sweating)

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neurosciencestuff:

Scientists Develop New Method to More Efficiently Generate Brain Stem Cells

In two newly published papers, a scientific team at Case Western Reserve University School of Medicine reports on the discovery and implementation of a new, more efficient method for generating an important brain stem cell in the laboratory. The findings pave the way for greater understanding of the underlying mechanisms of neurological disorders of myelin and ultimately, possible new treatment and prevention options. The studies were published in the September issues of Nature Communications and Stem Cell Reports.

“Making these specialized brain stem cells on a large scale at high purity from pluripotent stem cells gives us a powerful tool to study previously inaccessible normal and diseased tissues in the central nervous system,” said the senior author of the two papers, Paul Tesar, PhD, the Dr. Donald and Ruth Weber Goodman Professor of Innovative Therapeutics and associate professor of genetics and genome sciences at Case Western Reserve University School of Medicine. “We applied our technology to genetic models of myelin disease, which resulted in the discovery of a chemical compound that helps diseased myelin-producing cells to survive.”

Myelin, a fatty substance produced by cells called oligodendrocytes, coats nerve fibers and enables electrical signaling in the brain and facilitates normal neurological function.
Induced pluripotent stem cells are master cells that can potentially produce any cell the body needs. They are generated directly from existing adult cells. Embryonic stem cells are also pluripotent.

As reported in Nature Communications, first author Angela Lager, PhD, and colleagues developed a new methodology to generate large quantities of oligodendrocytes and their progenitor cells— known as oligodendrocyte progenitor cells or OPCs—from mouse embryonic stem cells and induced pluripotent stem cells. Many genes and cellular processes have been associated with oligodendrocyte dysfunction, but scientists have typically needed to make mutant mice to investigate these processes, often involving expensive, multi-year studies to examine a single aspect of this biology. To address this problem, the Case Western Reserve team developed a rapid and highly efficient method for generating OPCs and oligodendrocytes from pluripotent stem cells from any genetic background—providing new access to these relatively inaccessible brain cells in healthy and diseased states.

In Stem Cell Reports, first author Matthew Elitt, PhD, and colleagues leveraged this OPC generation technology to provide new insights and therapeutic strategies for a fatal genetic disorder of myelin, Pelizaeus Merzbacher disease (PMD). The team found that there was an unexpectedly early critical phase in PMD-affected cells characterized by endoplasmic reticulum stress and cell death as OPCs exit their progenitor state. The endoplasmic reticulum is the part of the cell involved in the processing of protein. In PMD, which almost exclusively affects male children, oligodendrocytes are lost and myelin is not properly formed in the brain and spinal cord. Due to their diseased myelin, children with PMD exhibit often-debilitating problems of coordination, motor skills, verbal expression, and learning. Due to the disease’s severity, patients typically die before adulthood.

To overcome this early cell death in PMD cells, the team screened thousands of drug-like compounds and found that one, known as Ro 25-6981, was especially successful in rescuing the survival of PMD oligodendrocytes in mouse and human cells in the laboratory and in PMD mice. “Our work is an important first step of a multi-phase process,” said Tesar. “We have achieved survival of oligodendrocytes which normally die in the disease. The next step is to figure out how to coax these cells to efficiently myelinate and restore function to patients.”

The Case Western Reserve team’s findings have implications beyond PMD. Numerous neurological and psychiatric diseases are characterized by myelin loss or dysfunction, including multiple sclerosis, spinal cord injury, and schizophrenia. Measures to regenerate or restore myelin could offer patients hope in these and numerous other disorders affecting the brain and spinal cord.

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irondad-not-ironsad:

aurora-nerin:

tea-rabbits:

ultimate-science-nerd:

positivelyqueerace:

dreamsrainandwitchythings:

intp-again:

muslimintp-1999-girl:

asexualchristian:

mentalmentalhealth:

girlwhorpsalot:

I needed this.

Thank you to all the people who posted this so I ended up seeing it. I really needed this right now. Thank you!

Yeah… Not gonna lie… I cried…

We need more people like this

Goddamn it stop making me feel human

The therapist I wanna be.

Text in the image:

“I’m a therapist and keep this poster in my waiting room, apparently it’s saved a few lives.”

I don’t like the phrase “a cry for help.” I just don’t like how it sounds. When somebody says to me, “I’m thinking about suicide. I have a plan: I just need a reason not to do it,” the last thing I see is helplessness.

I think your depression has been beating you up for years. It’s called you ugly, and stupid, and pathetic, and a failure, for so long that you’ve forgotten that it’s wrong. You don’t see any good in yourself, and you don’t have any hope.

But still here you are: you’ve come over to me, banged on my door and said, “HEY! Staying alive is REALLY HARD right now! Just give me something to fight with! I don’t care if it’s a stick! Give me a stick and I can stay alive!”

How is that helpless? I think that’s incredible. You’re like a marine: trapped for years behind enemy lines. Your gun has been taken away, you’re out of ammo, you’re malnourished, and you’ve probably caught some kind of jungle virus that’s making you hallucinate giant spiders.

And you’re still just going, “GIVE ME A STICK. I’M NOT DYING OUT HERE.”
“A cry for help” makes it sound like I’m supposed to take pity on you, but you don’t need my pity. This isn’t pathetic. This is the will to survive. This is how humans lived long enough to become the dominant species.

With NO hope, running on NOTHING, you’re ready to cut through a hundred miles of hostile jungle with nothing but a stick, if that’s what it takes to get to safety.

All I’m doing is handing out sticks.

You’re the one saying alive.

I legit cried at this. I’ve needed to hear it put this way. Bless this post.

Every time I see this post I stop to read the whole image. It always helps — even on the good days.

Because it wasn’t weakness. It wasn’t shameful to seek help. It wasn’t pathetic to “cry for help”. I was looking for a stick, be that from myself or from someone else. I was trying to find a way out. I was trying to heal myself.

this is fuckin incredible. 

I’m sorry if I repost to many of these, but if it could be someone’s “stick” then it’s worth it

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bpod-mrc:

Sound Maps

We navigate the world around us by creating maps of the things we see, smell, hear and touch. These ‘maps’ are a collection of cells organised topographically in the brain areas that process sensory cues from our environment. For sounds, cells that respond to a specific frequency are clustered next to cells for similar frequencies. To better understand how these maps are formed, a team of scientists genetically manipulated the auditory neurons of mice. They found that mouse embryos lacking a certain transcription factor didn’t have topographical maps in the cochlea (shown in this image) or inferior colliculus, two of the first sensory organs that relay auditory signals from the ear to the brain. This study presents some of the first evidence that there is a limit to how ‘plastic’ sensory pathways are, and that we rely on molecular cues in early development to create topographical maps of our environment.

Written by Gaëlle Coullon

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bpod-mrc:

Plugging Leaks

When it comes to building barriers, nature comes up trumps with the blood-brain barrier (BBB), a network of blood vessels supplying the brain which only allows select nutrients to pass through, blocking everything else. However, structures in the BBB called circumventricular organs (CVOs) are considerably leakier, allowing the brain to monitor blood changes and respond by triggering sensations such as thirst and hunger. Using mice and zebrafish, researchers investigated what happens when leaky CVO vessels are tightened up. Fluorescent microscopy of zebrafish brain blood vessels (red) revealed low levels of signalling molecules involved in BBB formation (green) in the zebrafish equivalent of the CVO (far left bottom region). Genetically altering mice to produce more of these molecules tightened up leaky CVO vessels but also impaired the ability of brain cells to correctly respond to water deprivation. These insights reveal more about how our most basic needs are controlled.

Written by Lux Fatimathas

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neurosciencenews:

How we make complex decisions

In a new study, MIT neuroscientists explored how the brain reasons about probable causes of failure after a hierarchy of decisions. They discovered that the brain performs two computations using a distributed network of areas in the frontal cortex. First, the brain computes confidence over the outcome of each decision to figure out the most likely cause of a failure, and second, when it is not easy to discern the cause, the brain makes additional attempts to gain more confidence.

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neurosciencestuff:

Psychologists at the University of Sussex have confirmed that the warm glow of kindness is real, even when there’s nothing in it for you. In their study, published in NeuroImage, they undertook a major analysis of existing research showing the brain scans relating to over 1000 people making kind decisions. For the first time, they split the analysis between what happens in the brain when people act out of genuine altruism – where there’s nothing in it for them – and when they act with strategic kindness – when there is something to be gained as a consequence.

Many individual studies have hinted that generosity activates the reward network of the brain but this new study from Sussex is the first that brought these studies together, and then split the results into two types of kindness – altruistic and strategic. The Sussex scientists found that reward areas of the brain are more active – i.e. use up more oxygen – when people act with strategic kindness, when there is an opportunity for others to return the favour.

But they also found that acts of altruism, with no hope of personal benefit, activate the reward areas of the brain too, and more than that, that some brain regions (in the ‘subgenual anterior cingulate cortex’) were more active during altruistic generosity, indicating that there is something unique about being altruistic with no hope of gaining something in return.

Dr Daniel Campbell-Meiklejohn, the study’s lead and Director of the Social Decision Laboratory at the University of Sussex, said:

“This major study sparks questions about people having different motivations to give to others: clear self-interest versus the warm glow of altruism. The decision to share resources is a cornerstone of any cooperative society. We know that people can choose to be kind because they like feeling like they are a ‘good person’, but also that people can choose to be kind when they think there might be something ‘in it’ for them such as a returned favour or improved reputation. Some people might say that ‘why’ we give does not matter, as long as we do. However, what motivates us to be kind is both fascinating and important. If, for example, governments can understand why people might give when there’s nothing in it for them, then they can understand how to encourage people to volunteer, donate to charity or support others in their community.”

Jo Cutler, the PhD student who co-authored the study at the University of Sussex, added:

“The finding of different motivations for giving raises all sorts of questions, including what charities and organisations can learn about what motivates their donors. Some museums, for example, choose to operate a membership scheme with real strategic benefits for their customers, such as discounts. Others will ask for a small altruistic donation on arrival. Organisations looking for contributions should think about how they want their customers to feel. Do they want them to feel altruistic, and experience a warm glow, or do they want them to enter with a transactional mind-set?”

“Given that we know there are these two motivations which overlap in the brain, charities should be careful not to offer something which feels like a token gesture, as this might undermine a sense of altruism. Sending small gifts in return for a monthly donation could change donors’ perceptions of their motivation from altruistic to transactional. In doing so, charities might also inadvertently replace the warm glow feeling with a sense of having had a bad deal.”

“The same issues could also apply when we think about interactions between family, friends, colleagues or strangers on a one-to-one basis. For example, if after a long day helping a friend move house, they hand you a fiver, you could end up feeling undervalued and less likely to help again. A hug and kind words however might spark a warm glow and make you feel appreciated. We found some brain regions were more active during altruistic, compared to strategic, generosity so it seems there is something special about situations where our only motivation to give to others is to feel good about being kind.”

Jo Cutler and Dr Campbell-Meiklejohn analysed 36 existing studies relating to 1,150 participants whose brains were scanned with fMRI scans over a ten-year period.

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neurosciencenews:

Groundbreaking genetic discovery shows why Lupus develops

Rare gene variants BLK and BANK1 are present in a substantial percentage of people with Lupus. The genetic variants suppress 1RF5 and type-1 1FN in B cells, causing dysfunction in the immune cells.

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neurosciencestuff:

Scientists Uncover Why You Can’t Decide What to Order for Lunch

If you’ve ever found yourself staring at a lengthy restaurant menu and been completely unable to decide what to order for lunch, you have experienced what psychologists call choice overload. The brain, faced with an overwhelming number of similar options, struggles to make a decision.

A study conducted in California nearly 20 years ago is illustrative of the effect. In that study, researchers set up a table offering samples of jams to customers in a grocery store. At times, 24 jam samples were provided; at other times, only six. It turned out that although shoppers were more likely to stop and try samples when the table was jam-packed, they also were much less likely to actually purchase any jam. Shoppers were somewhat less likely to stop at the table when it had only six jams, but when they did, they were 10 times more likely to make a jam purchase than the customers at the fuller table.

Lunch entrees and fruit preserves might seem trivial, but choice overload can sometimes have serious consequences, says Colin Camerer, Caltech’s Robert Kirby Professor of Behavioral Economics and the T&C Chen Center for Social and Decision Neuroscience Leadership Chair. As an example, he points to Sweden’s partial privatization of its social security system. The government allowed citizens to move some of their retirement savings into private funds. The government gave them hundreds of funds from which to choose, and conducted a large advertising campaign encouraging them to make their own choice. At first, nearly 70 percent of the eligible adult population took an active role in choosing a fund, but the percentage quickly dropped off. After 10 years, only about 1 percent of newly eligible Swedes were making an active decision about where to put their retirement money.

Now, a study conducted at Caltech by Camerer reveals new insights into choice overload, including the parts of the brain responsible for it, and how many options the brain actually prefers when it is making a choice.

In the study, volunteers were presented with pictures of scenic landscapes that they could have printed on a piece of merchandise such as a coffee mug. Each participant was offered a variety of sets of images, containing six, 12, or 24 pictures. They were asked to make their decisions while a functional magnetic resonance imaging (fMRI) machine recorded activity in their brains. As a control, the volunteers were asked to browse the images again, but this time their image selection was made randomly by a computer.

The fMRI scans revealed brain activity in two regions while the participants were making their choices: the anterior cingulate cortex (ACC), where the potential costs and benefits of decisions are weighed, Camerer says; and the striatum, a part of the brain responsible for determining value.

Camerer and his colleagues also saw that activity in these two regions was highest in subjects who had 12 options to pick from, and lowest in those with either six or 24 items to choose from. Camerer says that pattern of activity is probably the result of the striatum and the ACC interacting and weighing the increasing potential for reward (getting a picture they really like for their mug) against the increasing amount of work the brain will have to do to evaluate possible outcomes.

As the number of options increases, the potential reward increases, but then begins to level off due to diminishing returns. “The idea is that the best out of 12 is probably rather good, while the jump to the best out of 24 is not a big improvement,” Camerer says. At the same time, the amount of effort required to evaluate the options increases. Together, mental effort and the potential reward result in a sweet spot where the reward isn’t too low and the effort isn’t too high. This pattern was not seen when the subjects merely browsed the images because there was no potential for reward, and thus less effort was required when evaluating the options.

Camerer points out that 12 isn’t some magic number for human decision-making, but rather an artifact of the experimental design. He estimates that the ideal number of options for a person is probably somewhere between 8 and 15, depending on the perceived reward, the difficulty of evaluating the options, and the person’s individual characteristics.

Of course, a trip to the nearest grocery store is likely to reveal that lots of products come in many more than a dozen varieties. There might be a whole aisle of toothpastes of varying brands, sizes, flavors, textures, and properties, and on the condiment aisle, there might be dozens of kinds of mustards to choose from.

Camerer says that’s partly because people tend to feel freer and like they have more control over their lives when they have more options to choose from, even if having all those options ends up distressing them at decision time.

“Essentially, our eyes are bigger than our stomachs,” he says. “When we think about how many choices we want, we may not be mentally representing the frustrations of making the decision.”

Camerer says future research in this area could explore and attempt to quantify the mental costs of making a decision.

“What is mental effort? What does thinking cost? It’s poorly understood,” he says.

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bpod-mrc:

Finding the Beat

To keep our hearts beating in time the autonomic nervous system carries pulses of electrical activity deep into their muscular walls, causing repeating patterns of contractions. Usually hidden behind layers of fatty molecules, the nerves in this mouse heart are revealed in bright colours under a high-powered microscope after a chemical wash to clear the fats away. Computer algorithms help to spot the ‘circuits’ of nerves, colour-coding them by diameter (left, blue thinnest, red thickest) or by their orientation with the heart (right). These patterns reveal fresh details about how heart rhythm in maintained, but also provide a comparison for future studies – using similar techniques to examine how these patterns are disrupted by cardiovascular diseases and conditions such as myocardial infarction.

Written by John Ankers

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