Depression/Bipolar Flashcards
SSRI-induced activation is most common from which 2 SSRI’s?
Prozac
Zoloft
On average how long do pediatric depressive episodes last?
7 months
What % of children with an initial depressive episode will have their depression resolve spontaeously?
40%
What are the 2 FDA approved meds for MDD?
- Prozac (8+ y/o)
- Lexapro (12+ y/o)
What % of individuals diagnosed with Bipolar disorder had symptoms between the age of 13-18 and before 13y/o?
13-18: 40%
Before 13y/o: 25%
What percentage of patients with Bipolar disorder had symptoms beginning at age 13 or earlier?
25-30%
What is the primary finding of the Treatment of Adolescent Depression Study (TADS)?
Fluoxetine + CBT resulted (combo) in greater rate of remission of depressive symptoms
The Treatment of SSRI-resistant Depression in Adolescents (TORDIA) trial looked at adolescents who had not responded to a previous 2 month course of an SSRI. Meds used were: Paroxetine, Citalopram, Fluoxetine, Venlafaxine. Patients who switched to another SSRI and added CBT had a response rate of ______?
Which of the meds was associated with increased side effects?
55% response rate, no difference in which med was switched to
Venlafaxine associated with increased SE
What 8 meds are FDA approved for pediatric Bipolar disorder?
- Lithium (mania/mixed/maintenance, >7y/o)
- Abilify (mania/mixed/maintenance, >10y/o)
- Asenapine (mania, >10y/o)
- Olanzapine + fluoxetine combo (bipolar one depression, >10y/o)
- Risperidone (mania, >10y/o)
- Seroquel XR (mania, >10y/o)
- Olanzapine (mania, >13y/o)
- Lurasidone (bipolar depression, >10y/o)
- Lamictal (maintenance/depression) ?
AALLOORS*
What commonly precedes an adolescent suicide attempt?
confessing suicidal thoughts to a friend
How often does the FDA recommend following up with a youth started on an AD?
every week for the first month, then every other week thereafter
The prevalence of MDD is approximately _____% in children and ______% in adolescents.
2% in children
4-8% in adolescents
DECREASED OR INCREASED
Sleep disturbances have been implicated in depression. This includes ____ REM latency, _____ REM density, and _____ sleep efficiency.
Decreased REM latency
Increased REM density
Decreased sleep efficiency
The boxed warning on AD was based on a review of placebo-controlled short term studies of ___ (#?) of AD. The review found that the risk of suicidal thoughts and behaviors was 2.1% in subjects taking placebo and 3.8% in subjects taking the active medication. FDA black box warning recommends close monitoring of children and adolescents taking SSRI meds for first ___(#?) weeks of treatment.
9 studies
4 weeks
T/F:
Small hippocampal volume has been identified as a risk factor for early-onset depression.
True
Inflammation is considered to play a role in the development of depression. This is found through _____ (inc/dec) levels of interleukin-6 and C-reactive protein.
INCREASED
What age must you have displayed symptoms by in order to be dx with DMDD?
symptoms by 10y/o
What is the recommended first-line treatment for the child and adolescent bipolar depression starting at age 10?
Latuda (lurasidone)
T/F: Acetylsalicylic acid (Aspirin) should not be combined with valproic acid because acetylsalicylic acid may increase the blood level
True leading to valproic acid toxicity
______ is approved by the FDA for the prevention of recurrence of mania in patients aged 12 years and older.
Lithium
What drug shows reductions in substance use in adolescents with bipolar disorder and comorbid substance use disorder
Lithium
What 2 medications are FDA approved for tx of mania in kids 10 or older?
Abilify
Risperidone
What age is Lithium approved for tx of mania?
12 and older
