management of depression

Question 1

Mild depression mx

Answer 1

1. Conservative therapy

• exercise regime
• alcohol + life style advise
• individual self help based on CBT principle

Question 2

Moderate depression mx

Answer 2

1. Conservative therapy
2. CBT
3. Antidepressant therapy - SSRI

Question 3

Severe depression mx

Answer 3

1. Antidepressant therapy / Medical therapy

2. ECT

Question 4

When is ECT indicated?

Answer 4

patients with severe depression refractory to medication

Question 5

Name 3 short term side effects of ECT?

Answer 5

1. headaches
2. nausea
3. short term memory

Question 6

When is ECT contraindicated?

Answer 6

raised intra cranial pressure

Question 7

Ix of Depression

Answer 7

1. FBC
2. U and E
3. LFT - GGT/MCV ( alcohol misuse)
4. TFT - hypothyroidism

Question 8

Differential diagnosis of depression

Answer 8

1. Dementia
2. Hypothyroidism
3. Grief

Question 9

symptoms of depression vs dementia

signs its more likely depression than dementia

Answer 9

1. short history + rapid onset
2. biological symptoms - weight loss/sleep disturbance
3. patients worried about poor memory loss
4. global memory loss - dementia characteristically causes recent memory loss