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Mood/Affective Disorders Flashcards

1
Q

MDD RF

A

FAMILY hx
female
20-40s

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2
Q

MDD definition

A

depressed mood or anhedonia (loos of pleasure) or interest in activities with >5 associated symptoms for at least 2 weeks

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3
Q

MDD associated symptoms

A

fatigue, insomnia/hypersomnia, guilt/worthlessness, thoughts of death/suicide, psychomotor agitation, significant weight change, appetite change

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4
Q

somatic MDD symptoms

A 
constipation 
HA
skin changes
chest/abdominal pain 
cough/SOB
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5
Q

MDD subtypes

A
  1. seasonal affective d/o
  2. atypical depression
  3. melancholia
  4. catatonic depression
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6
Q

seasonal affective d/o

A

presence of depressive symptoms at the same time of year

tx: SSRI, Wellbutrin, light tx

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7
Q

atypical depression

A

typical MDD but mood reactivity - elevated mood in response to good things

significant weight gain/increased appetite, hypersomnia, heavy/leaden feelings, oversensitivity to rejection

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8
Q

tx of atypical depression

A

MOA inhibitors

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9
Q

melancholia

A

anhedonia, lack of mood reactivity, depression ,severe weight loss, guilt, sleep issues

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10
Q

catatonic depression

A

motor immobility, stupor and extreme withdrawal

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11
Q

who has higher suicide rate?

A

detailed plan, white males >45, concurrent substance abuse

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12
Q

principal tx in MDD

A

psychotherapy

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13
Q

medications first line

A

SSRIs

need to be taken 3-6 weeks to determine efficacy

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14
Q

MDD that fails to respond to tx, what option?

A

ECT

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15
Q

SSRI MOA

A

inhibit CNS uptake of serotonin

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16
Q

SSRI indication

A

first line for anxiety and depression

easy dosing, less SEs, low toxicity

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17
Q

who does NOT get citalopram?

A

long QT syndrome

AKA celexa

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18
Q

s/es of SSRI

A

GI upset, sexual dysfunction, HA, changes in energy

CAN cause suicidal thoughts

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19
Q

serotonin syndrome

A

acute AMS seizures, restlessness, diaphoresis, tremor, hyperthermia, n/v/abdominal pain, mydriasis, tachycardia

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20
Q

SNRI

A

inhibition of serotonin, norepinephrine, and dopamine reuptake

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21
Q

indications of SNRI

A

firt line in its with significant fatigue or pain syndrome in depression

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22
Q

SSNRI s/es

A

hypertension, dizziness, hyponatremia

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23
Q

caution SSNRI

A

MAOI use. renal/liver issues, seizures

increased risk of serotonin syndrome if used with St. John’s Wort

24
Q

TCA MOA

A

inhibit serotonin and norepinephrine reuptake

25
TCA indications
depression, insomnia, diabetic neuropathy, post-hepatic neuralgia, migraine, fibromyalgia,
26
why don't we use TCAs that much
side effect and severe toxicity with One Direction
27
TCA s/es
anticholinergics, sedation, weight gain, prolonged QT, sinus/wide complex tachycardia, neuropathy symptoms, ARDS, SIADH
28
tx for TCA toxicity
sodium bicarb
29
indicator of TCA OD
wide complex tachycardia | prolonged QT
30
tetracyclic compoiunds MOA and indication
enhances noradrenergic and serotonergic activity indicated in depression, less sexual issues, can be used with trazadone
31
s/es of tetracyclic cmpds
section, dry mouth, constipation c/I with MAO I
32
bupropion hydrochloride MOA/indication
inhibits dopamine, norepinephrine uptake indication for depression and smoking
33
s/es bupropion hydrochloride
seizures, agitation, anxiety, weight loss HTN, LESS GI AND SEXUAL issues
34
C/I bupropion hydrochloride
seizure d.o and eating disorder drug ETOH detox
35
MAO I | MOA and indication
blocks NT breakdown indicated in refractory depression
36
SEs of MAOI
insomnia, anxiety, hypotension, weight gain, sexua hypertensive crisi
37
MAOI CI
serotonin syndrome if used with SSRI may cause delirium and hypertension if with TCA
38
trazodone
antidepression, anti anxiety, hypnotic affects s/es: section and cardiac arrhythmias
39
Bipolar I
>1 manic/mixed episode, cycles with occasional depressive episodes
40
RF of Bipolar I
family history strongest risk factor
41
mania
abnormal and persistently elevated, expansive, or irritable mood lasts 1 week marked impairment of social/occupational function
42
mania mood
euphoric, irritable, labile, dysphoric
43
mania htinking
racing, flight of ideas, disorganized, easily distracted, expansive, grandiose
44
mania behavior
physical hyperactivity, pressured speech, decreased need for sleep increased impulsivity, excessive involvement in pleasure activity
45
management of Bipolar I
mood stabilizers (lithium 1st line, valproic acid, carbamazepine) Haldol/benzos if manic (psychosis or agitation)
46
antidepressants and Bipolar
can precipitate mania
47
bipolar II
>1 hypomanic episode + >1 MDD episode mania or mixed episodes absent
48
hypomania
similar to manic elevated, expansive or irritable mood x 4+ days NO marked impairment, no psychosis, no hospitalization
49
Management of acute mania Bipolar II
lithium** also antipsychotics and vends
50
management of depression in Bipolar II
lithium valproate or carbamazepine
51
persistant depressive disorder
chronic depressed mood >2 years more mild than MDD but no mania symptoms, patients can function typicall progresses over time
52
clinical manifestations of dysthymia
1. loss of interest, withdrawal, pessimism 2. chronic depressed mood >2 yrs, "I've always been this way," no symptom free periods 3. at least 2 of the MDD symptoms met
53
tx of dysthymia
SSRIs and psychotherapy can also try SNRI, Bupropion, TCAs and MOA
54
cyclothymic disorder
similar to bipolar II but LESS SEVERE prolonged period of milder elevations and depressions in mood
55
cyclothymic d/o manifestations
1. recurrent hypomanic symptoms that don't meet hypomania criteria that CYCLE with relatively mild depression AT LEAST 2 years
56
tx of cyclothymic d/o
mood stabilizers and neuroleptics

PSYCH EOR (4 decks)

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