Depression, Schizophrenia (Psychosis), Bipolar Disorder, ADHD, GAD & Sleep Disorders Flashcards
Depression
M SIG E CAPS
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
Antidepressant withdrawal symptoms include _____ & ______.
Tachycardia & Anxiety
Treat depression when ________ to ______ symptoms and reassess ______ weeks
Moderate to Severe
4- 8 weeks
First line agents for depression include
SSRI
SNRI
Mirtazapine
Bupropion
Alternative agents for depression include
Aripiprazole
Olanzapine + Fluoxetine
Quetiapine XR
Brexpiprazole
Buspirone
Lithium
Thyroid hormone
ECT
GAD First line Treatment
SSRIs
SNRI
GAD 2nd line treatment
Buspirone
TCAs
Hyroxyzine (Vistaril)
Pregablin (Lyrica)
Gabapentin (Neurontin)
Propranolol
Last line: BZD
Schizophrenia & Psychosis
Though disorder
Schizophrenia & psychosis Positive symptoms
Hallucination
Delusion
Disorganized thinking/behavior
Tardive Dyskinesia: Uncontrolled movements of face, tongue or other parts of the body
Negative symptoms
Alogia = loss of speech
Avolition = Loss of motiviation
Social withdrawal
Apathy = lack of emotion
Loss of interest in daily activity
First line drugs for schizophrenia
SGAs
FGAs
Tardive Dyskinesia treatment
Valbenazine (Ingrezza)
NMS
Taper antipsychotic
Consider Quetiapine or Clozapine
Cool down: Bed, Antipyretics, Cooled IV fluids
Muscle relaxation: BZDs or Dantrolene (Ryanodex, Dantrium, Revonto) or Bromocritpine
Bipolar Disorder
Bipolar I: one episode of mania (Hospitalization)
Bipolar 2: One episode of hypomania lasting > 4 days & one depressive episode lasting > 2 weeks
Manic treatment
Valproate or Lithium +/- Antipsychotic
Depressive episode treatment
Bipolar
Lithium
Lamotrigine
Valproate
Carbamazepine
Maintenance Bipolar treatment
Mono-therapy: Lithium or Valproate
Alternative: Lamotrigine, Carbamazepine or SGAs
ADHD
Inattention
Impulsivity
Hyperactivity
Difficulty focusing or easily distracted
Unable to control impulsive behavior
ADHD Diagnosis
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
Stimulants recommended for Age ___
6 years +
1st line treatment ADHD
Long acting formulation
Methylphenidate (Ritalin)
Dexmethylphenidate (Focalin)
Dextroamphetamine-Amphetamine (Adderall)
Lisdexamfetamine (Vyvanse)
Methamphetamine (Desoxyn)
2nd line treatment for ADHD
Non-stimulants
Atomoxetine (Strattera)
Guanfacine ER (iNTUNIV)
Clonidine ER (Kapvay)
Insomnia
Difficulty falling asleep
Symptoms > 3x/week x 3 months
Treatment of insomnia
Eszopiclone
Zolpidem
Falling Asleep: Ramelteon or Zaleplon
Staying asleep: Doxepin or Suvorexant
