Depression Flashcards
What is first line for depression in Parkinson’s?
SSRIs
What is the prevalence of depression in Parkinson’s?
20%
In what % of cases do depressive symptoms precede motor symptoms?
30%
Why should TCAs be avoided in depression in Parkinson’s?
They can cause confusion and cognitive impairment
Why antidepressant should be avoided in depression in Parkinson’s as it can worsen sleep quality?
Mirtazapine
which factors are likely to cause depression in patients suffering from Parkinson’s?
- left sided brain injury
- family hx of depression
- low dopamine levels in the limbic system
- cognitive impairment
- loss of functional independence
Which antidepressants have lower risk of sexual dysfunction side effects?
- Bupropion
- Mirtazapine
Which antidepressants should be avoided in Parkinson’s?
TCAs
Which symptom is least likely to be different between young and old people suffering from depressive disorder?
Sleep disturbance
Which symptoms are to be different between young and old people suffering from depressive disorder?
- Behavioural disturbances
- Complaints of loneliness
- Poor concentration and memory
- Paranoid and delusional ideation
Antidepressants in the elderly
- Newer antidepressants such as SSRI SNRIs are better tolerated as they have lesser side effects
- those who show resistance to first-line treatment tend to do well with lithium augmentation
- EECT is the most effective treatment for life-threatening depressive disorder.
What is a good prognostic factor for depression in the elderly?
Female gender
What are poor prognostic factor for depression in the elderly?
- male gender
- history of dysthymia
- atypical features
- active medical illness or poor physical health
Stress and depression often increase the risk of coronary artery disease by which biological markers?
- Interleukin 6
- Fibrinogen
- natural killer cells
- von Willebrand factor
What combination of medication has been found to be effective in treatment resistant depression?
“Californian rocket fuel” is a medical slang term for the combined administration of mirtazapine (a NaSSA) and venlafaxine (an SNRI). This combination is usually used in the treatment of treatment-resistant depression.
Which symptom is less likely to occur in adolescent onset depression vs adult onset?
Psychomotor retardation
What is the one year prevalence of depression?
5.3%
What is the life time prevalence of depression?
13%
What is the mean age of onset of depression?
30
What is the mean number of episodes in patients with MDD?
5 episodes
What is the most common comorbidity in patients with MDD?
Alcohol abuse
What percentage of patients with MDD attempt suicide?
9%
What proportion of patients diagnosed with depression by their GP go on to have an episode of mania within 10 years?
1 in 10
How long does an untreated episode of depression last?
6 to 13 months (compared to 3 months if treated)