impulse control, ED, sexual DO

Question 1

What biochemical changes are seen in pts wth intermittent explosive DO? what is the best pharm tx?

Answer 1

low serotonin

treat with SSRIs, esp fluoxetine, anticonvulsants, Li, anti-psychotics, and propranolol

Question 2

What is a common comorbidity with kleptomania?

Answer 2

bulimia- up to 25%

Question 3

how often does binging and compensation have to occur to meet diagnostic criteria for bulimia

Answer 3

2x/wk for 3 months

Question 4

what are the definitions of acute vs chronic insomnia?

Answer 4

acute- 1-4 wks

chronic >1 month

Question 5

What are the best drugs for cataplexy?

Answer 5

sodium oxybate is first line. then try TCAs like imipramine and clomipramine, and or SSRIs or SSNRIs

Question 6

What is kleine-levin syndrome?

Answer 6

recurrent hypersomnia with episodes of daytime sleepiness with hyperphagia, hypersexuality, and aggresion

Question 7

When does sleepwalking occur? important associations?

Answer 7

during slow wave sleep; more common in kids with hyperthyroidism or OSA

Question 8

When do sleep terrors occur?

Answer 8

also during slow wave sleep. involve sympathetic hyperactivation

Question 9

what is the most effective drug for rem sleep behavior syndrome?

Answer 9

clonazapam