depression Flashcards
mean age of onset?
20s
reduced function of which systems in the brain?
serotonin and noradrenergic
3 main symptoms
low mood
anhedonia
anergia
differential diagnosis?
hypothyroid, cushings, steroids, b blockers
chronic mild depression for a minimum of 2 years in which episodes are either not long enough or severe enough to meet criteria for depression?
dysthymia
what investigations can you do?
FBC, LFT, TFT
classification of depression?
mild moderate severe mixed atypical
In distress but able to continue with activities of daily living?
mild depression (need 2 core symptoms and 2 additional symptoms)
need 2 core symptoms and 4 additional symptoms. associated with difficulty carrying out activities of daily living
moderate
what is mixed depression ?
depression mixed with GAD
severe depression definition ?
2 core symptoms + 4 additional symptoms. Associated with hopelessness, worthlessness, suicidal ideation, somatic symptoms and complete inability to carry out activities of daily living
what is atypical depression?
biological symptoms are reversed. There is an associated increase in sleep, appetite and weight
what is ECT reserved for?
very treatment resistant or life saving
TCA - what might you see on ECG?
QT prolongation
what is the normal QT time?
0.36-0.44 seconds
what is serotonin syndrome ?
consumption of excessive amounts or multiple drugs that causes increase in amount of serotonin
what drugs can cause serotonin syndrome?
SSRI, TCA, MAOI, amphetamine, opioids, anti consultants, triptans, lithium.
what would a patient with SS present like ?
dilated pupils, nausea, diarrhoea, tachycardia, twitching, tremor, rigidity, hyper reflexia
Investigation of SS?
toxicology screen
management of SS?
stop drugs
supportive treatment
measures to cool patient
benzos to reduce anxiety and sedate the patient
minimum duration for duration of symptoms to be classified as depression?
2 weeks
safest TCA in overdose?
lofepramine
ECT therapy - is there any risk of epilepsy from this?
no
in older people, depression can manifest in ?
physical symptoms
