Mes fam-PSY Flashcards
T or F: 50% of pts with cancer develop sx of depression before the dx
T
Nommer 4 rx pouvant causer des sx dépressifs
b-bloqueurs, BZD, glucocorticoïdes, interferon
Criteria for depression: more than 5/9 + anhedonia or depressed mood for more than 2 weeks
M-SIGECAPS M: mood (depressed) S: increased/ decreased sleep I: decreased interest G: guilt E: decreased energy C: decreased concentration A: increased/decreased appetite and weight P: psychomotor agitation/ retardation S: suicidal ideation
in depression, combination therapy with psychological tx and medication is associated with greater improvement than Rx alone, and decreased dropout rate: T or F
T
high yield sceening questions for depression (3)
and should we routinely screen it?
are u depressed?
have u lost interest or pleasure?
do u have problem sleeping?
No routine screening
Name a scale to screen, dx and monitor depression
PHQ9 (personal health questionnaire depression scale), GDS for geriatrics
investigation médicale pour dépression
TSH, FSC, B12, BH, urée, créat, ferritine, électrolytes, glycémie
phases of tx for depression
acute phase (8-12 w) to relieve sx
maintenance phase (6-12 m after sx resolution): important to continue Rx
tx of youth 10-21 years old
mild: active support and monitoring
fluoxetine is first line: monitor for suicidal ideation and behaviour
Do not use paroxetine-Paxil!
psychotherapy: CBT or IPT (interpersonal therapy)
tx should continue 6m at least
referral if moderate/severe with psychosis or subs abuse
how long before u should reassess or refer a depressive pt after starting Rx
6-8 w
Name 6 SSRI
paroxetine-paxil fluoxetine-prozac sertraline-zoloft citalopram-celexa fluvoxamine-luvox escitalopram-cipralex
action of ssri
block serotonin reuptake
side effects of SSRI (8)
sexual disfct, headache, GI upset, weigh tloss, tremors, insomnia, fatigue, increased QT interval (baseline ECG suggested)
Name 2 SNRI
Venlafaxine-effexor
duloxetine-cymbalta
action of SNRI
block serotonin and NE reuptake
