6 - Depression Flashcards

1
Q

How long do you need to treat for once in remission?

A

6-9 months

if severe, recurrent, chronic, etc. then do 2 years treatment

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2
Q

Non-pharms?

A

therapy, exercise

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3
Q

For pharmacologic treatment:
Min therapeutic dose should be reached in first ___ weeks of treatment and then increase if necessary over the next 4-6 weeks

A

2

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4
Q

side effects of SSRIs

A

GI, CNS, sexual dysfunction

*sexual dysfunction is more likely to stay all throughout treatment, while GI and CNS side effects will improve

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5
Q

At high doses of venlafaxine, what can happen?

A

can increase BP @ doses > 225 mg/day

*monitor BP and avoid in those with uncontrolled HTN

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6
Q

What is the active metabolite of venlafaxine?

A

desvenlafaxine

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7
Q

Bupropion also used for ?

A

also used for smoking cessation

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8
Q

who is bupropion CI in ?

A
  • those with history of or current anorexia or bulimia

- those with history of or current seizure disorder

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9
Q

s/e of bupropion

A
  • less GI disturbance compared to SSRIs

- no sexual s/e

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10
Q

Bupropion + _____ decreases seizure threshold

A

alcohol

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11
Q

s/e of mirtazapine?

A
  • sedation and weight gain

* less risk of GI and sexual s/e

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12
Q

Avoid irreversible MAOis with _____ containing foods

A

tyramine

*cheese, meats, ripe fruit

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13
Q

Washout period:

Irreversible MAOi to any other antidepressant

A

2 weeks

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14
Q

Washout period:

Any other antidepressant to irreversible MAOi

A

5 half lives

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15
Q

Washout period:

From moclobemide to any other antidepressant

A

5 day washout

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16
Q

Washout period:

Fluoxetine to an irreversible MAOi

A

5 weeks

17
Q

Can also use _____ for depression

A

antipsychotics

18
Q

Which NHPs are proven effective for mild depression?

A
  • St. John’s Wort
  • SAM-e

*both can increase risk for serotonin syndrome when used with other serotonergic meds

19
Q

Choice for depression in pregnancy?

A
  • SSRIs

* not paroxetine

20
Q

Choice for depression in breastfeeding?

A

sertraline, escitalopram or citalopram

*paroxetine and sertraline are detected in low amounts in breast milk

21
Q

When do you assess for remission?

A

6-8 weeks after they are at therapeutic dose