Affective disorders Flashcards
What are the three core symptoms of depression?
- Anhedonia
- Low mood
- Fatiguability
The content of delusions and hallucinations in depression tend to be consistent with the patient’s mood, i.e. they are mood _________
Congruent (as opposed to mood incongruent)
Dysthymia
Chronically depressed mood that is not severe enough to satisfy the formal criteria for a depressive episode.
Cyclothymia
Mild elation and depression (seen as a subthreshold form of bipolar)
To diagnose a depressive episode, what’s the minimum time symptoms must be present for?
2 weeks
Name 7 physical causes of depression
1) Hypothyroidism
2) Cushing’s syndrome
3 + 4) Parathyroid disease (hypo and hyper)
5) Stroke
6) Multiple sclerosis
7) Low folate and vit b12
What prescription drugs are known to cause low mood?
- Beta blockers
- Anti-hypertensives: Methyldopa
- Corticosteroids
- COCP
- Phenytoin
- Benzos
- Indometacin.
What is the male:female ratio for:
1) BPAD
2) Depression
1) 1:1
2) 1:2
Both negative and positive life events can trigger mania. Name 3 other environmental triggers of mania
1) The puerperium
2) Sleep deprivation
3) Flying across time zones
Name two rating scales for depression
- Beck depression inventory (BDI)
- Hospital and Anxiety depression scale (HADS)
How long do you have to wait for antidepressants to become effective?
4-6 weeks
How long should symptoms be present to diagnose a manic episode?
Symptoms should be present at least one week and should prevent work and ordinary social activities
What is Lithium’s therapeutic range?
0.6 - 1.0 mmol/L
What the three main mood stabilizers used in the treatment of mania?
- Lithium
- Sodium valproate
- Carbamazepine
Lithium toxicity occurs in levels greater than _____?
1.2mmol/L
How does lithium toxicity present?
GI disturbance, sluggishness, giddiness, ataxia, gross tremor, fits and renal failure
What drugs may interfere with lithium excretion?
NSAIDs, diuretics & ACEi
Mood stabilizers are teratogenic.
-Lithium can cause _________
-Valproate and carbamazepine risk __________
- Lithium can cause Ebstein’s anomaly (atrialization of the right side of the heart)
- Valproate and carbamazepine risk spina bifida
Another drug, which is effective against Bipolar II disorder? (i.e. mainly depressive episodes with less prominent hypomanic episodes)
Lamotrigine
Lithium can cause toxicity. Which other mood stabilizer can?
Carbamazepine
The following are side effects of which anticonvulsants?
a) Liver failure , thrombocytopenia, hair loss, weight gain
b) Rash, leukopenia, dizziness, ataxia, drowsiness, fatigue, oedema, weight gain, hyponatremia
a) Valproate
b) Carbamazepine
