Management of Mood Disorders Flashcards
name four scales used to assess mood
IDS-30-SR
QIDS
hospital anxiety and depression scale
MADRS
what is the “best” SSRI?
escitalopram
give two reasons why sertraline may be chosen over other drugs
good cardiac safety
allows easy dose titration
give two reasons why mirtazapine may be chosen over other drugs
promotes sleep and weight gain
less likely to cause nausea or sexual side effect s
if combination therapy is needed for depression, what is usually given?
SSRI/SNRI and mirtazapine
what should be done to prevent a relapse of depression in the first episode?
continue antidepressant for at least six months after full recovery without reducing the dose
what should be done to prevent a relapse of depression in the second (or higher) episode?
continue antidepressant for at least 1-2 years after full recovery without reducing the dose
what are the two main principles of managing a manic/hypomanic episode?
maximise antimanic dose if the patient is on maintenance treatment
discontinue antidepressants
what is the first line drug class for acute mania?
antipsychotics
name three antipsychotics that may be given first line in acute mania?
olanzapine
quetiapine
risperidone
name four other treatment options in acute mania
lithium
valproate
carbamazepine
ECT
when should antidepressants be avoided in acute bipolar depression?
those with a recent manic/hypomanic episode
history of rapid cycling
what should an antidepressant be given with in acute bipolar depression?
anti-manic drug
what antidepressant is preferable in acute bipolar depression?
SSRIs
especially fluoxetine
what is the gold standard long term treatment for bipolar maintenance?
lithium
