General Flashcards
What is DBT used for
Dialectical behaviour therapy (DBT) is increasingly used for personality disorder with borderline features.
Self harm for young people
Reviewing post initiation of anti depressant in 18-25 year olds
Review in 1 week
PTSD management
Only treat if 1 month or more
Trauma focused CBT
If more than 3 months, eye movement desensitisation therapy
Medications - sertraline, paroxetine, venlafaxine (off lisence)
Sodium valproate monitoring
Fbc, lft, weight
Lithium monitoring
Levels 12 hours after dose (0.4-1)
FBC, u&e, calcium, weight/ bmi, lipids, TFt
Lithium levels checked weekly, then 3 monthly for first year, then 6 monthly
U&e TFT, bmi 6 monthly
Lithium monitoring
Levels 12 hours after dose
FBC, u&e, calcium, weight, lipids, TFt
Antidepressants used in bipolar disease
Fluoxetine
Antidepressant to use in patients on warfarin, nsaids etc
Mirtazapine as SSRIs increase risk of gi bleeding
Switching fluoxetine to another antidepressant
Stop it for 7 days, them start new one
(Fluoxetine has a long half life)
Antidepressant meds should be continued for how long after symptoms improve for
Depression
Panic disorder
GAD
6 months
6 months
1 year
Eating disorders red flags that need immediate admission
Temp less than 35.5.
HR less than 40
BMI < 13
Weight loss of 1kg in 2 weeks
Hb < 10
SSRI discontinuation syndrome most common drug
Paroxetine ( has short half life)
Gastrointestinal disturbances, headache, anxiety, dizziness, paraesthesia, electric shock sensation in the head, neck and spine, tinnitus and sleep disturbances, fatigue, influenza-like symptoms and sweating are the most common features of abrupt withdrawal of an SSRI or a marked reduction of the dose.
Smoking and effect on antidepressants
Smoking increases metabolism of antidepressants
So if u stop smoking, consider reducing the dose 25%
