Alternative Treatments for Mood Disorders Flashcards
What can anti-psychotics be used for in bipolar disorder?
Treatment and prophylaxis of both manic/hypomanic and depressed states in bipolar disorder
When can anti-psychotics be used in unipolar depression?
Combined with an anti-depressant in unipolar depression with or without psychotic symptoms
What are some possible side effects of atypical anti-psychotics?
Sedation, weight gain, metabolic syndrome, constipation and prolonged QT syndrome
What tests must be done before starting an atypical anti-psychotic?
BP, weight, lipids, glucose, ECG, FBC, Us and Es and LFTs
After starting an atypical anti-psychotic, how often should all the relevant tests be done?
At 1 months, and then yearly thereafter
Which type of anti-psychotic is used more commonly in mood disorders?
Atypical
What is the main mechanism of action of anti-psychotic drugs?
D2 receptor blockade
What are some side effects of typical anti-psychotic drugs?
EPSE, sedation, dizziness, long QT syndrome, hyperprolactinaemia
How often is ECT usually given?
Twice a week
Is unilateral or bilateral ECT more common?
Bilateral
If unilateral ECT is given, what side is it on?
The non-dominant side, so usually right
In ECT, a dose of electricity is titrated for each patient to achieve what?
A seizure which typically lasts 15-20 seconds
How quickly do patients ‘recover’ following ECT?
Within minutes
66% of people will usually complain of a side effect following ECT. What is important about this?
The side effect will usually be mild and self-limiting and respond to symptomatic treatment
What type of memory loss can occur following ECT?
Short term memory loss, most accentuated for the time closest to treatment
Does memory loss as a result of ECT recover?
Usually, though a minority cases are persistent
If a person’s capacity is impaired, what is needed before ECT can go ahead?
A second opinion from an independent secondary doctor
Is a second opinion needed for life saving ECT?
No
Can you give ECT to a person who has capacity and is refusing treatment, but is detained under the mental health act?
No
Which type of ECT is more likely to cause cognitive issues?
Bilateral
Which type of ECT is faster and more effective?
Bilateral
What are the absolute contra-indications to ECT?
Recent MI or cerebrovascular event within the last 3 months, intracranial mass lesion or phaeochromocytoma
What are the relative contra-indications to ECT?
Angina or congestive heart failure, severe pulmonary disease, severe osteoporosis, pregnancy
