Mood/affective Disorders Flashcards
What is the first line treatment for mild depression?
Psychological intervention (via the improving access to psychological therapies referral).
How to manage persistent sub-threshold depressive symptoms?
Sleep hygiene and active monitoring
Consider antidepressants for those: with history of severe depression, persistent over 2 years, chronic health problems.
Psychological therapy: individual guided self help based on CBT. Computerised CBT. Group physical activity programme.
What’s St. John’s wort?
Hypericum perforate - flowering plant.
Thought to be as successful as tricyclics in treating mild-mod depression.
P450 enzyme inducer
Reduces levels of warfarin, cyclosporine, and cocp
S/e - photosensitivity, dizziness, GI, fatigue,
What is a hypnopompic hallucination?
Occurring from sleeping to waking. They are normal but more associated with depression and anxiety.
And sleep paralysis
Rx - if troublesome clonazepam may be used
What’s the difference between mania and hypomania?
Don’t get psychotic symptoms in hypomania
What are this classifications of BPAD?
Manic (1 week) causes impairment
Hypomanic (<4days)
Rapid cycling - four or more episodes in the past year
Problems with antidepressant use in BP depression?
Induce mania
Cause rapid cycling
Tca > Snri > maoi > ssri
Which conditions are antidepressants used?
Depressive disorders.
Anxiety disorders
OCD
Bulmeia
What drugs are effective in bipolar depression?
Quetiapine
Lamotrigine
Which is the least toxic TCA?
Lofepramine
Treatment for acute mania?
Second generation antipsychotics eg olanzipine, quetiapine, risperidone
Or valproate semisodium
What’s the prophylactic treatment for bipolar?
Lithium carbonate
2nd line - semisodium valproate or carbimazipine
