Depressive Disorders

Question 1

Give the ICD10 criteria for depression diagnosis

Answer 1

2 out of 3 core symptoms every day for at least two weeks
Low mood
Low energy
Anhedonia

Question 2

Apart from the core symptoms, give some other symptoms that indicate depression

Answer 2

Lack of concentration
Excess guilt or negative thoughts
Suicidal ideation
Mood variation
Sleep disturbance
Loss of libido
Appetite loss/weight loss
Hallucinations or delusions

Question 3

What is the immediate management for depression?

Answer 3

Assess the risk
Reassess the patient in two weeks if not severe or high risk
Refer to psychiatry if severe, recurrent, suicide risk or bipolar

Question 4

Give examples of SSRIs

Answer 4

Sertraline
Fluoxetine
Citalopram

Question 5

Name 2 SNRIs

Answer 5

Venlafaxine

Duloxetine

Question 6

Give examples of TCAs

Answer 6

Amitryptiline
Imipramine
Nortryptiline

Question 7

What is the mechanism of action of mirtazapine?

Answer 7

Atypical
NASSA
Increases NA and serotonin

Question 8

What are the common side effects of mirtazapine?

Answer 8

Abnormal dreams
N+V
Anxiety 
Confusion and dizziness
Tremor

Question 9

What is the medical management for resistant depression?

Answer 9

Antidepressant +

Lithium, antipsychotic or another antidepressant

Question 10

What psycho-social management should be recommend for patients with depression?

Answer 10

CBT
Support groups
Sleep hygiene
Physical activity