Depression, Schizophrenia (Psychosis), Bipolar Disorder, ADHD, GAD & Sleep Disorders

Question 1

Depression

M SIG E CAPS

Answer 1

Mood = depressed

Sleep = increased/decreased
Interest/Pleasure = Diminished
Guilt = feeling or worthlessness

Energy = decreased

Concentration = decreased
Appetite = increased/decreased
Psychomotor = agitation or retardation
Suicidal ideation

5 of symptoms during the same 2 week period & must include
1. Depressed mood
2. Diminished interest or pleasure

Question 2

Antidepressant withdrawal symptoms include _____ & ______.

Answer 2

Tachycardia & Anxiety

Question 3

Treat depression when ________ to ______ symptoms and reassess ______ weeks

Answer 3

Moderate to Severe

4- 8 weeks

Question 4

First line agents for depression include

Answer 4

SSRI
SNRI
Mirtazapine
Bupropion

Question 5

Alternative agents for depression include

Answer 5

Aripiprazole
Olanzapine + Fluoxetine
Quetiapine XR
Brexpiprazole

Buspirone
Lithium
Thyroid hormone
ECT

Question 6

GAD First line Treatment

Answer 6

SSRIs
SNRI

Question 7

GAD 2nd line treatment

Answer 7

Buspirone
TCAs
Hyroxyzine (Vistaril)
Pregablin (Lyrica)
Gabapentin (Neurontin)

Propranolol

Last line: BZD

Question 8

Schizophrenia & Psychosis

Answer 8

Though disorder

Question 9

Schizophrenia & psychosis Positive symptoms

Answer 9

Hallucination
Delusion
Disorganized thinking/behavior
Tardive Dyskinesia: Uncontrolled movements of face, tongue or other parts of the body

Question 10

Negative symptoms

Answer 10

Alogia = loss of speech
Avolition = Loss of motiviation
Social withdrawal
Apathy = lack of emotion
Loss of interest in daily activity

Question 11

First line drugs for schizophrenia

Answer 11

SGAs
FGAs

Question 12

Tardive Dyskinesia treatment

Answer 12

Valbenazine (Ingrezza)

Question 13

NMS

Answer 13

Taper antipsychotic
Consider Quetiapine or Clozapine
Cool down: Bed, Antipyretics, Cooled IV fluids
Muscle relaxation: BZDs or Dantrolene (Ryanodex, Dantrium, Revonto) or Bromocritpine

Question 14

Bipolar Disorder

Answer 14

Bipolar I: one episode of mania (Hospitalization)
Bipolar 2: One episode of hypomania lasting > 4 days & one depressive episode lasting > 2 weeks

Question 15

Manic treatment

Answer 15

Valproate or Lithium +/- Antipsychotic

Question 16

Depressive episode treatment
Bipolar

Answer 16

Lithium
Lamotrigine
Valproate
Carbamazepine

Question 17

Maintenance Bipolar treatment

Answer 17

Mono-therapy: Lithium or Valproate
Alternative: Lamotrigine, Carbamazepine or SGAs

Question 18

ADHD

Answer 18

Inattention
Impulsivity
Hyperactivity
Difficulty focusing or easily distracted
Unable to control impulsive behavior

Question 19

ADHD Diagnosis

Answer 19

Symptoms present > 6 months

more than 6 symptoms for children up to age 16 or
more than 5 symptoms for ages 17+

Symptoms present in 2+ settings
interfere with functioning & are not caused by other disorders

Question 20

Stimulants recommended for Age ___

Answer 20

6 years +

Question 21

1st line treatment ADHD

Answer 21

Long acting formulation
Methylphenidate (Ritalin)
Dexmethylphenidate (Focalin)
Dextroamphetamine-Amphetamine (Adderall)
Lisdexamfetamine (Vyvanse)
Methamphetamine (Desoxyn)

Question 22

2nd line treatment for ADHD

Answer 22

Non-stimulants
Atomoxetine (Strattera)
Guanfacine ER (iNTUNIV)
Clonidine ER (Kapvay)

Question 23

Insomnia

Answer 23

Difficulty falling asleep
Symptoms > 3x/week x 3 months

Question 24

Treatment of insomnia

Answer 24

Eszopiclone
Zolpidem

Falling Asleep: Ramelteon or Zaleplon
Staying asleep: Doxepin or Suvorexant

Question 25

RLS

Answer 25

Uge to move lower legs “Creeping” sensation due to dysfunction of DA

Question 26

RLS Treatment

Answer 26

Pramipexole (Mirapex)
Ropinirole (REQUIP)
Rotigotine (Neupro)

Gabapentin (Horizant)
Fluoxetine (Sarafem)

Question 27

Narcolepsy

Answer 27

Excessive day time sleepiness with cataplexy (Sudden loss of muscle tone)

Question 28

Narcolepsy treatment

Answer 28

Modafinil (Provigil)
Armodafinil (Nuvigil)
Sodium Oxybate (Xyrem)