First Aid Mood Disorders and Anxiety Disorders Flashcards
criteria major depressive disorder
at least 5 Sx for at least 2 weeks:
depressed mood anhedonia change in appetite or body weight feelings of worthlessness or excessive guilt insomnia or hypersomnia diminished concentration psychomotor agitation or retardation fatigue or loss of energy recurrent thoughts of death or suicide
criteria for manic episode
at least 3 Sx of at least 1 week:
distractibility inflated self esteem increased in goal directed activity decreased need for sleep flight of ideas or racing thoughts more talkative or pressured speech excessive involvement in pleasurable activities that have high risk of negative consequences
hypomanic episode
distinct period of elevated, expansive or irritable mood that includes at least 3 of the Sx
what can cause mania
antidepressants sympathomimetics dopamine corticosteroids levodopa bronchodilators
when are women more likely to have major depressive disorder
W>M during reproductive years
W=M before menses and post menopause
anhedonia
inability to experience pleasure
main NT abnormality in MDD
decreased serotonin and its metabolite 5HIAA
main antidepressant medication groups
SSRIs
TCAs
MAOIs
which SSRIs also work on other NT
venlafaxine- effexor
duloxetine- cymbalta
bupropion- wellbutrin
side effects TCAs
sedation, weight gain, orthostatic hypotension and anticholinergic effects
MAOIs useful for what
refractory depression
risk for what with MAOIs
hypertensive crisis when used with sympathomimetics or ingestion of tyramine rich foods
risk of serotonin syndrome when used with SSRIs
most common side effect is orthostatic hypotension
what can you add to drug regiment to convert nonresponders to responders
liothyronine, levothyroxine, lithium or L tryptophan
first line Tx atypical depression
MAOI
5 stages of grief
denial anger bargaining depression acceptance
Dx Bipolar I disorder
one manic or mixed episode
between can have episodes of depression, euthymia, dysthymia, hypothymia. these episodes are not required for Dx
side effects lithium
weight gain tremor GI disturbances fatigue cardiac arrhythmias seizures goiter/hypothyroidism leukocytosis coma polyuria polydipsia alopecia metallic taste
what drugs are used for rapid cycling bipolar disorder
carbamazepine or valproic acid
what are the atypical antipsychotics
olanzapine, quetiapine, ziprasidone
bipolar II
Hx of 1+ major depressive episodes with at least one hypomanic episode
difference of dysthymic disorder and MDD
dysthymic is persistent
MDD is episodic
diagnosis of dysthymic disorder
depressed mood for majority of time for at least 2 years
at least 2: poor concentration, hopelessness, insomnia/hypersomnia, low energy or fatigue, low self-esteem
no manic or hypomanic. no MDD and not without Sx for more than 2 months at a time.
cyclothymic disorder diagnosis
numerous periods of hypomania and periods with depression for at least 2 years
not symptom free for more than 2 months
no history of major depressive episode or manic episode
triad for seasonal affective disorder
irritability
carbohydrate craving
hypersomnia
