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Depression > CANMAT Guidelines > Flashcards

CANMAT Guidelines Flashcards

1
Q

What are first-line recommendations for pharmacologic treatment of depression?

A

SSRI, SNRI, bupropion, mirtazapine, vortioxetine and agomelatine

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2
Q

Newly approved medications for MDD

A

Vortioxetine, Vilazodone, Levomilancipran

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3
Q

What are second-line recommendations for pharmacologic treatment of depression?

A

TCA, quetiapine, trazodone (inc SE burden)
Moclobomide, selegiline (serious drug interactions)
Levomilanacipran, vilazodone

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4
Q

What are third-line recommendations for pharmacologic treatment of depression?

A

MAOI, reboxetine

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5
Q

T or F: antipsychotic + anti-depressant combination is more effective for MDD with psychotic features than placebo, mono-therapy AP or mono-therapy AD

A

True (Cochrane review)

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6
Q

Which medications have been shown to be superior to placebo in mixed depressive episodes?

A

Lurasidone, ziprasidone

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7
Q

Which anti-depressants have shown to improve cognitive function in depressed patients?

A

SSRI, bupropion, duloxetine, moclobemide, tianeptine
Vortioxetine

systematic review (35 studies)
found low-quality evidence that SSRIs, bupropion,
duloxetine, moclobemide, and tianeptine (an antidepressant
with limited availability) improve cognitive domains such as
learning, memory, and executive function.31 In a metaanalysis
(17 studies, N ¼ 3653) reviewing the cognitive
effects of antidepressants based on neuropsychological tests,
vortioxetine had the largest effects on processing speed,
executive control, and cognitive control, while duloxetine
had the largest effects on delayed recall.17

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8
Q

Which medications have been shown to be effective in improving sleep in depressed patients?

A

Agomelatine, mirtazapine, trazodone, quetiapine

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9
Q

Which class of medication is effective in pain conditions?

A

SNRIs

especially duloxetine

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10
Q

Which AD have evidence for superior efficacy based on meta-analyses?

A

Escitalopram (compared to citalopram, duloxetine, fluoxetine, fluvoxamine, paroxetine)

Mirtazapine (duloxetine, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine)

Sertraline (duloxetine, fluoxetine, fluvoxamine, paroxetine)

Venlafaxine (duloxetine, fluoxetine, fluvoxamine, paroxetine)

Agomelatine (fluoxetine, sertraline)

Citalopram (paroxetine)

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11
Q

Recommendations for MDD with anxious distress

A

Use an antidepressant with efficacy in GAD (Level 4)

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12
Q

Recommendations for MDD with catatonic features

A

Benzo (Level 3)

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13
Q

Recommendations for MDD with melancholic features

A

No specific antidepressants have demonstrated superiority (Level 2)

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14
Q

Recommendations for MDD with atypical features

A

No specific antidepressants have demonstrated superiority (level 2)

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15
Q

Recommendations for MDD with psychotic features

A

Use antipsychotic and antidepressant cotreatment (Level 1)

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16
Q

Recommendations for MDD with mixed features

A

Lurasidone (Level 2)

Ziprasidone (Level 3)

17
Q

Recommendations for MDD with seasonal pattern

A

No specific antidepressants have demonstrated superiority (Level 2 and 3)

18
Q

Recommendations for MDD with cognitive dysfunction

A 
Vortioxetine (Level 1)
Bupropion (Level 2)
Duloxetine (Level 2)
SSRIs (Level 2)
Moclobemide (Level 3)
19
Q

Recommendations for MDD with sleep disturbances

A

Agomelatine (Level 1)
Mirtazapine (Level 2)
Quetiapine (Level 2)
Trazodone (Level 2)

20
Q

Recommendations for MDD with somatic symptoms

A 
Duloxetine - pain (Level 1)
Other SNRIs - pain (Level 2)
Bupropion - fatigue (Level 1)
SSRIs - fatigue (Level 2)
Duloxetine - energy (Level 2)

Depression (2 decks)

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