Major Depressive Disorder: Therapeutics

Question 1

Documentation of Axes

Answer 1

1 - ID of major disorders.
2 - Personality or Development disorders.
3 - Physical problems.
4 - Severity of stress.
5 - Current level of functioning.

Question 2

Mental Status Exam (MSE)

Answer 2

1 - Appearance and Behavior.
2 - Speech and Language.
3 - Mood/Emotional stability.
4 - Thoughts and Perceptions.
5 - Cognitive function, including MMSE.

Question 3

Mini-Mental Status Exam

Answer 3

1 - Orientation to Time, Place, and Person.
2 - Attention.
3 - Types of memory: Remote and Recent.
4 - Higher cognitive functions of information and vocabulary.
5 - Calculating ability, Abstract thinking with analogies, and Constructional Ability in Coping Figures.

Question 4

Diagnostic Criteria for MDD

Answer 4

"D-SIG-E-CAPS" - 5 or more with at least...
DEPRESSION - Overall mood.
Sleep - More or less.
INTEREST (Anhedonia) - Decreased.
Guilt - Unnecessarily.
Energy - Decreased.
Concentration - Decreased.
Appetite - Increased or Decresed.
Psychomotor Changes - Sluggish.
Suicidality - Thoughts and/or Acts.

Question 5

Medical Disorders associated with MDD

Answer 5

Hypothyroidism.
Low T.
Chronic diseases as a whole.
Drug induced.

Question 6

PHQ-9

Answer 6

Patient Health Questionnaire-9
Self-report screening tool for MDD.
5 = mild.
10 = moderate.
15 = severe.

Question 7

Interactions to consider with Antidepressants

Answer 7

CYP P450 Interactions.
SSRI’s and Blood Thinners - Increased risk of bleeds.
MAOI’s and Foods - Tyramine, Hypertensive crisis.
Serotonin Syndrome - Hyperthermia.

Question 8

GLAD-PC

Answer 8

SSRI dosing schedules for Adolescents.

Question 9

Safe Antidepressant for Geriatrics

Answer 9

Mirtazepine

Question 10

Safe Antidepressant for Pregnancy

Answer 10

Sertraline

Question 11

Sources of Information for Lactation and Antidepressant Teratogenicity

Answer 11

OTIS

Brigg’s