Depression

Question 1

time frame for dx

Answer 1

at least 5 symptoms present for 2 weeks

Question 2

which two must be present for dx

Answer 2

depressed mood or loss of interest/pleasure

Question 3

DSM-5 criteria for depression

Answer 3

(+ 1 of the other two musts!)

• weight loss/gain
• insomnia/hypersomnia
• psychomotor agitation/retardation
• fatigue/loss of energy
• worthlessness/inappropriate guilt
• diminished ability to think/concentrate, indecisiveness
• recurrent thoughts of death

Question 4

SIG E CAPS

Answer 4

Sleep issues
Interest deficit
Guilt, worthlessness, regret

energy

concentration issues
appetite disorder
psychomotor retardation/agitation
suicidality

Question 5

suicide risk

Answer 5

8th leading cause of death in US - 30,000 deaths/year,

15% depressed taken own lives, risk is greatest after initiation of tx

Question 6

age and suicide

Answer 6

suicide attempts decrease with age, but completion/success of suicide increases with age

Question 7

who is at highest risk of suicide

Answer 7

middle age white men

Question 8

first line tx of depression

Answer 8

SSRI

Question 9

SSRI dosing

Answer 9

flat dose curve - more is not necessarily better

Question 10

SSRI AE

Answer 10

nausea, loose stools, HA , insomnia, sexual dysfunction, jitteriness, muscle tension

Question 11

SSRI examples

Answer 11

fluoxetine, citalopram, fluvoxamine, paroxetine, sertraline

Question 12

SNRI’s

Answer 12

good to use with ppl who are in pain
positive dose response
start with lower dose and titrate up

Question 13

SNRI’s AE

Answer 13

increase BP and HR, and LFT’s

Question 14

SNRI’s examples

Answer 14

venlafaxine (effexor), duloxetine (cymbalta)

Question 15

Serotonin syndrome

Answer 15

excess serotonin

Question 16

Serotonin syndrome S/Sx

Answer 16

confusion, flushing, diaphoresis, tremor, myoclonic jerks

Question 17

Wellbutrin CI

Answer 17

lowers seizure threshold