Depression- 18C Flashcards
1
Q
How long should person stay on medication after successful remission of first MDE
A
6-12 months
2
Q
Indications for ECT in depression
A
- depression with psychotic features
- previous good response to ECT
- fast response needed
- intolerance of meds
- treatment failures
3
Q
Define adequate trial of antidepressant
A
- 4-8 weeks at therapeutic dose
- 12 weeks in the elderly
4
Q
Define treatment resistant depression
A
-failure respond to at least 2 anti-depressants of adequate doses and duration from 2 distinct classes
5
Q
Medications FDA approved for depression treatment augmentation
A
- ABILIFY
- SEROQUEL
- BREXIPIPRAZOLE
6
Q
Other augmentation strategies
A
- LITHIUM
- T3
- RITALIN (elderly)
7
Q
Name serious adverse effects of SSRI’s/SNRI’s
A
- bleeding/bruising: decreased platelet adhesion
- hyponatremia (SIADH)
- Serotonin Syndrome (myoclonic jerks)
- Discontinuation syndrome
- HTN with SNRI’s
- Acute closure glaucoma
8
Q
Name the SRI modulators
A
- Vilazodone (3A4- ketokonazole, grapefruit juice, erythromycin)
- Vortioxitene (2D6- Fluoxetine, Paroxetine)
9
Q
When should DULOXETINE be avoided
A
- substantial alcohol ue
- chronic hepatic disease
- severe renal disease
10
Q
The triad of Serotonin Syndrome
A
- mental status changes
- autonomic instability (diaphoresis)
- neuromuscular changes (hyper-reflexia)
11
Q
Serotonin Syndrome vs. NMS
A
-SS more likely
hyper-reflexia, myoclonus, n/v/d
less rigidity & hyperthermia
