Chapter 16- Emotional and mood disorders Flashcards
What’s the etiology of clinical depression?
-Characterized by sad or despondent mood
Symptoms of depression
- lack of energy
- sleep disturbances
- abnormal eating patterns
- feelings of despair, guilt, hopelessness
Postpartum depression
Intense mood changes associated with hormonal changes
Seasonal affective disorder
-enhanced release of melatonin due to lower light levels
Psychotic depression
-intense mood shifts; unusual behaviors
Major depressive disorder
-depressed affect plus 5 of the following symptoms for a minimum of 2 weeks
- difficulty sleeping or sleeping too much
- extremely tired; without energy
- vague physical symptoms
- inability to concentrate or make decisions
- feelings of despair, guilt, misery; lack of self worth
- obsession with death
- avoidance of psychosocial or interpersonal reactions
- lack of interest in personal appearance or sex
- delusions or hallucinations
What is the role of the nurse when pt. receiving antidepressants
- ask about alcohol and drug use; suicidal ideation
- obtain family history of depressive illness
- obtain drug history
Education for client receiving antidepressants
- diet education related to foods that contain tyramine
- info on signs and symptoms of dehydration and lithium toxicity
- education on prescribed drug treatment
Tricyclic antidepressants mechanism of action
- decrease reabsorption of norepinephrine and serotonin
- correct the imbalance in the neurotransmitter concentrations at the nerve endings in the CNS
What are tricyclics antidepressants used for?
- major depressive episodes
- panic disorders
- OCDs
Tricyclic drug examples
- elavil
- sinequan
Adverse effects of tricyclics
- dry mouth
- urinary difficulty
- constipation
- blurred vision
- tremors, headache, weight gain, insomnia, photosensitivity, orthostatic hypotension
- overdoses are usually lethal
- dysrhythmias with cardiac arrest
- seizures
Inhibitors(SSRIs)…what do they do?
- selectively inhibit serotonin reuptake into the presynaptic terminals
- this increases amount of serotonin at the nerve endings
Examples of SSRIs
- Prozac
- Paxil
- Zoloft
- celexa
- lexapro
Major advantage of the SSRIs…
Greater safety!
Most common side effect of SSRIs…
Sexual dysfunction
Examples of atypical antidepressants
- cymbalta
- effexor
Atypical antidepressants were originally designed to…
Treat depression and cause minimal cardiovascular effects, fewer anticholinergic effects, less sedation, and less sexual dysfunction than other antidepressants
Monoamine oxidase inhibitors (MAOIs) mechanism of action
-inhibit monoamine oxidase (the enzyme that terminates the actions of neurotransmitters such as dopamine, norepinephrine, epinephrine, and serotonin)
Common side effects of MAOIs
- orthostatic hypotension
- headache
- insomnia
- diarrhea
Primary concern of MAOIs…
Interact with large number of foods and other medications
foods containing TYRAMINE
