Exam 4: Treatment

Question 1

Tricyclics (depression)

Answer 1

block NE & 5HT reuptake and alters sensitivity of receptors; Imipramine; take 10 days, not high risk, helps 50-60%

Question 2

MAOIs (depression)

Answer 2

block MAO from degrading NE, problem with rise in blood pressure getting to potentially dangerous levels, so try Tricyclics first, helps 50%

Question 3

SSRIs (depression)

Answer 3

inhibit 5HT reuptake; Prozac, Zoloft, Lexapro, Celexa; can affect sleep cycles and sex drive, may increase suicide rates in kids and adolescents; as affective as tricyclics with less side affects

Question 4

NRIs (depression)

Answer 4

Strattera; only affect NE

Question 5

SNRIs (depression)

Answer 5

affect NE & 5HT; effexor and cymbalta

Question 6

Medication and Children (depression)

Answer 6

less research; may be less effective than for adults and more consern about use due to lots of serotonin connection growth from 11-18

Question 7

Electroconvulsive Therapy (ECT) (Depression)

Answer 7

given muscle relaxants and anesthetics so it is safer for patients; confined to severe depression resistent to treatment; only put electrode on 1 side of head to reduce symptom of memory loss; helps 60-80%

Question 8

Transcranial Magnetic Stimulation (TMS) (Depression)

Answer 8

looks promising and doesn’t scare people as much as ECT and has no memory problems, electrode coil cap on head distributes current to frontal cortex; done daily for 2-4 weeks

Question 9

Lithium (Bipolar)

Answer 9

blood salt; brings people down from mania and prevents mania as well as depression; seems to affect NE & 5HT, breakdown of second messengers, and sodium ions
problem: theraputic dose is close to toxic dose which can create kidney damage so people are monitored
side affects: hand tremors, weight gain, restlessness, nausea

Question 10

Antiseizure Drugs (Bipolar)

Answer 10

Lamictal, Depakot, Tegretol; used like mood stabilizers; sometimes more than one is used at a time, other times with lithium

Question 11

Beck’s Cognitive Therapy (depression)

Answer 11

recognize and change automatic thoughts, originally developed for depression, sometimes incorporates useful behavioral techniques, develop and practice alternative cognitions (cognitive restructuring)

Question 12

New Wave Cognitive (depression)

Answer 12

Acceptance and commitment therapy: don’t base your behavior on your thoughts

Question 13

Interpersonal Psychotherapy (IPT) (depression)

Answer 13

psychodynamic; focuses on the cycle between depression and relationships; problem areas of grief/loss, interpersonal disputes, role transitions, and interpersonal deficits; given patient role; treatment pulls from different therapies (cognitive restructuring, problem solving, acceptance, practicing skills); improves social interactions

Question 14

Psychodynamic Therapy (depression)

Answer 14

depression results from unconscious grief over real or imagined losses compounded by excessive dependence on other people; use free association, and working through past problems

Question 15

Couples/Family Therapy (depression)

Answer 15

depression can result from marital problems; people with depression have dysfunctional relationships; therapist helps change harmful behaviors with teaching communication and problem-solving skills; individual with depression is often also in individual therapy

Question 16

Adjunctive Psychotherapy (bipolar)

Answer 16

psychotherapy alone is rarely effective for bipolar; use individual/group/family therapy with drugs; emphasize importance of taking meds, improve social skills, educate patient/family, problem solving, preventing suicide; helpful in reducing hospitalization, keeping jobs, and improves social functioning

Question 17

NIMH Study (depression)

Answer 17

CBT, IPT, Tricyclic, Placebo - 16 weeks
240 people with mod/severe depression, 21-65
all 3 groups were equally successful and all better than the placebo group