Affective disorders Flashcards
What is an affective disorder?
a group of mental illnesses which affects ones mood, thought, behaviour, and emotions.
Give some examples of an affective disorder
OCD
PTSD
Anxiety
Depression
Bipolar
What causes affective disorders?
Genetics
Environmental factors
Drugs
Physical illness
Biochemical
Endocrine
what is the treatment for depression
Mild- non-pharmacological treatments
severe- SSRIs
Why should patients be informed of the withdrawal effects of anti-depressants?
they have negative side effects which can worsen
For Treatment resistant depression what is the treatment
Antipsychotics and lithium (mood stabilisers)
What guidelines are we looking at when we are looking at mental health
Maudsley guidelines
What are the principles of prescribing for depression?
discuss non-pharmacological treatments
discuss side-effects
What are SNRIs
serotonin noradrenaline reuptake inhibitors
What is first line for depression
SSRI
How do these drug work?
They inhibit the affects of serotonin reuptake
What receptors do they work on?
A range of receptors includind CYPs
Name a few SSRIs?
Fluoxetine, paroxetine, sertraline, citalopram, escitalopram,
What side effects are associated with SSRIs?
nausea, insomnia , sexual dysfunction
What is the more serious side effects
What are the drugs interaction for SSRIs
Interactions with CYP142 with fluoxetine - causes increased theophylline levels
Interactions with CYP2D6 with fluoxetine - causes increased risk of seizure
Interactions with CYP2D6 with paroxetine - causes cancer treatment failure as it reduces affects of tamoxifen
What does SSRIs cause and how long are the effects seen
What are the adverse effects of SSRIs?
gastrointestinal, sexual dysfunction, gastrointestinal bleeding (due to inability to make blood clots properly), discontinuation syndrome and increased suicide thoughts
What are the factors to do with SSRIs and increased risk of bleeding?
Serotonin is released from platelets following a vascular injury. this causes vasoconstriction and changes in platelets leading to aggregation. this causes decreased ability to form clots
What group of patients do we need to worry about when giving SSRIs?
Patients who have:
- active ulcer disease
- Take drugs that can cause GI injury
- PPIs
- Elderly with a history of GI bleeding
- People fresh from a surgery
- Haemostatic defects, drug-induced or natural
How do tricyclic antidepressants work? Give two examples.
What adverse effects do tricyclic antidepressants lead to?
What monitoring needs to be done?
What are MAOIs
What types of effects do we have to be aware of?
What to do if the patient does not respond to the drugs chosen?
What is st johns wort?
What are the adverse effects of st Johns wort?
What are the drug interactions with st johns wort?
What do we say about anti depressants in general?
What do the nice guidelines say about the duration of anti-depressants?
What drugs do we use for the sexual dysfunction of anti depressants?
What are the factors needed to start and stop anti-depressants?
What is hyponatremia caused by?
How can we monitor patients with hyponatremia?
Who has an increased risk of hyponatraemia?
What is treatment resistant depression
How does the STAR-D program help with?
What is the first choice options for TRD
What is the second option in TRD
What is venlafaxine?
What is bipolar disorder?
What is mania?
What is the main treatment for this disorder?
What are the goals for bipolar?
Give some examples of drugs used to treat this disorder.
What is the recommended drugs for BPD?
What is lithium used for ?
What is the down side of lithium?
What can you say about the plasma levels of lithium?
What are the adverse effects of lithium ? and describe the effects of its toxcity?
What are the interactions with lithium?
What are the pre-treatment tests?
What are the monitoring requirements?
What antiepileptic drug is used for bipolar
What antipsychotic drugs are used in bipolar?
Are anti-depressants useful in bipolar?
What are the recommendations for the prophylaxis of BP?
