42. suicide Flashcards
Pt pop to screen for suicidal thoughts (6)
chronic illness
mental illness
substance use problems;
recent loss or emotional distress;
impulsivity; or
repeated suicidal ideation or attempts
assess degree of risk (4)
thoughts
specific plans
access to means
impulsivity
qqn avec automutilation, ne pas assumer que c’est un geste
suicidaire
Acetaminophen (tylenol) poisoning treatment
N-acetylcysteine
someone coming with drug overdose, always screen for (2)
1) acetylsalicylic acid
2) acetaminophen overdoses
Mngmt low risk (5)
safety plan
- Keep home environment safe (remove access to weapons)
- Recognize early warning signs
- Coming up with ways to cope personally with suicidal thoughts
- Identify people to contact for help/distraction
- Identify place to go to for safety (eg. hospital)
Mngmt high risk vs
1) Emergency psychiatric consultation and in-patient treatment if unsafe to self/others
types of therapy that could help
Cognitive behavioural therapy
Interpersonal psychotherapy
Behavioural activation
Group (less effective than individual but lower costs)
E2 when stopping antidepressants
FINISH
(Flu-like symptoms, Insomnia, Nausea, Imbalance, Sensory disturbance, Hyperarousal
children and breast feeding anti-depressant tx
citalopram (cheapest)
escitalopram
sertraline
brand name Sertraline
(Zoloft)
brand name venlafaxine
(Effexor)
brand name citalopram
celexa
brand name
escitalopram
cipralex
brand name
fluoxetine
prozac
1st line tx kids antidepressant (after cbt)
fluoxetine - prozac
peri-menopausal 1st line anti-depressant tx
Desvenlafaxine
Late-Life (≥60yo) anti-depress tx 1st line and 2nd line
Duloxetine, mirtazapine, nortriptyline
the rest citalopram etc
brand name Desvenlafaxine
pristiq
duloxetine brand name
cymbalta
mirtazapine brand name
remeron
nortriptyline brand name
Aventyl
pts at suicide risk (personnal risk)
SAD PERSONS
