Depression Flashcards
1
Q
how do you ensure good sleep hygiene?
A
- establishing regular sleep wake times
- avoid eating excess, drinking or smoking before bed
- ensure healthy sleeping environment
- take regular physical exercise
2
Q
what would you consider in an older person taking an SSRI and aspirin/ NSAID?
what SSRI is associated with a high incidence of discontinuation symptoms?
A
- gastroprotection
- paroxetine
3
Q
what kind of things do you need to provide information on when prescribing antidepressants?
A
- gradual development of full antidepressant effect
- potential side effects
- importance of taking medications prescribed
- the risk and nature of all discontinuation symptoms (like withdrawal but no craving for drug) particularly in short half life drugs (paroxetine and venlafaxine)
4
Q
how long do you need when changing from fluoxetine to another drug?
why do you need to wait when switching from an SSRI to an MAOI?
A
- 1 week, long half life
- high risk of serotonin syndrome (especially in fluoxetine)
5
Q
what is combining and augmentation in psychiatry?
A
- combining: when two antidepressants are used together
- augmentation: when an antidepressant is used with a non antidepressant, (e.g. lithium or antipsychotic)
- make sure you speak to consultant psychiatrist before doing this.
6
Q
what must be monitored when starting lithium and how often?
A
- monitor renal and thyroid function at the start and every 6 months during treatment
- consider ECG in those at high risk of CV symptoms
- monitor serum lithium levels 1 week after initiation or dose change AND every 3 months thereafter.
7
Q
how long should a person take antidepressants for after remission of symptoms?
A
- 6 months
