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
RLS
Uge to move lower legs “Creeping” sensation due to dysfunction of DA
RLS Treatment
Pramipexole (Mirapex)
Ropinirole (REQUIP)
Rotigotine (Neupro)
Gabapentin (Horizant)
Fluoxetine (Sarafem)
Narcolepsy
Excessive day time sleepiness with cataplexy (Sudden loss of muscle tone)
Narcolepsy treatment
Modafinil (Provigil)
Armodafinil (Nuvigil)
Sodium Oxybate (Xyrem)
