Depression Flashcards
Symptoms
- Depressed mood or irritability in children/adolescents
- Marked diminished interest or pleasure in activities
- Significant weight loss or gain
- Insomnia OR hypersomnia
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthiness or guilt
- Diminished concentration
- Indecisiveness
- Thoughts of death/suicide
In MDD, the pt has depressed mood or lost of interest for how long?
At least 2 weeks
Most common co-morbidity
Alcohol abuse or dependence
Pre-disposing biological factors
Decreased monamines, increased acetylcholine
- CVA
- AD
- Parkinson’s, Huntington’s, MS, Traumatic brain injury, electrolyte imbalances
- Nutritional deficiencies
Pre-disposing factors - meds
Steroids, hormones, sedatives, antibiotics, antineoplastics, analgesics
Elderly symptoms
Memory loss, confusion, apathy
Adolescent symptoms
Anger, aggressiveness, social withdrawal, academic problems, substance abuse, change in behavior
How is depression missed/masked/not identified?
Stigma, masked by substance abuse, denial, co-existing medical conditions
Tung Self-Rating Depression Scale
Beck Depression Inventory
PHQ-9
PHQ-2
Self administered depression rating scales
Hamilton depression scale
Clinician administered depression scale
Chronic/severe depression treatment
Combined therapy: psychotherapy + medications
Antidepressant black box warning
Increased risk of suicidality in children and adolescents
Length of treatment
6 months - 1 year
What should you do when coming off the drug?
Taper slowly
How long does it takes for meds to take effect?
4-6 weeks
Recurrence
is common
Side effects of SSRI/SNRI
H/A, nausea, weight gain/loss, INSOMNIA, SEXUAL DYSFUNCTION
Adverse effect of SSRI/SNRI
Serotonin Syndrome
Serotonin syndrome is what type of interaction
drug-drug
Symptoms of serotonin syndrome
Diarrhea, restlessness, agitation, hyperreflexia, autonomic instability, seizure/delirium, coma, cardiovascular collapse
How do you treat serotonin syndrome?
Stop the med, meds that block serotonin receptors
Nursing Implications in Depression
Identify, prevent, active listening, support
