Mood Disorders Flashcards
What are the symptoms of a major depressive episode?
- Changes in motor function
- Changes in sleep pattery
- Changes in weight
- Depressed mood
- Disturbance in the ability ot concentrate or remember things
- Feelings of worthlessness, guilt, or shame
- Loss of daily energy
- Loss of interest in life activities
- Thoughts of dying, including suicidal thoughts
What are the two types of depression?
- Typical
- decreased sleep, appeite, memory, concentration, libido
- increased energy
- Atypical
- drastically increased sleep & appetite
- decreased memory concentration, libido
- drastically decreased energy
What is the acronym for diagnosisn depression?
- S - sleep
- A - appetite
- M - memory
- C - concentration
- E - energy
- L - libido
- (s) - suicidal ideation / homicidal ideation & hallucination
What are the key neurotransmitters in treating depressive episodes?
serotonin
norepinephrine
dopamine
What are the factors that influence medication selection to treat depression?
- Weight Gain
- Sexual Dysfunction
- Cytochrome P450 Med-Med Interaction(s)
- Potential of Overdose Lethality
- Mechanism of Action
- Withdrawl Phenomenon
- Speed of Onset of Efficacy
When do we stop treatment for depression?
- side effects
- patient requests
- patient discontinues of own volition
- Protocol
- < 55 - once remission reached; continue 6 - 9 months
- < 55 - remission reached, medication discontinued & symptoms recur - treat again x 2 yrs
- < 55 remission reached, medication discontinued, symptoms recur, retreat x 2 yrs then after 2nd remission sympotoms recur - treatment for life
- > 55 treatment for life
How can you differentiate between withdrawl & recurrance of another episode?
If you give them another does & all those symptoms go away - discontinuation syndrome b/c wont treat the depression with one dose
What are the 3 types of bipolar disorder?
- Type I
- at least one manic episode
- Type II
- at least one hypomanic episode with at least one depressive episode
- Type III
- mixed – ittitability, excitability, agitation, depressed mood, happy mood
What is the term for :
distinct period of consistently elevated, expansive, or irritable mood that lasts for at least 4 days and is clearly different from the patients usual non-depressed mood
hypomanic episode
What are the characteristics of a hypomanic episode?
- change from usual mood
- observable by others
- non severe enough to caue marked impairment in social or occupational function or require hospitilization
3 + of the following symptoms
- inflated self-esteem or grandiosity
- decreased need for sleep – patient feels rested w/ 3 hrs
- increased talking or pressure of speech
- flight of ideas or subjective feeling of racing thoughts
- easily distracted / dificulty staying focused
- increase in social, work/school, or sexual goal directed activity or psychomotor agitation
- engaging excessively in pleasurable activities that have a great potential for harmful consequences such as unrestrained spending sprees, sexual indiscretions, foolish business investments
What is a manic episode?
elevated, irritable, expansive mood for at least one week (unless hospitalized)
+
3 + of
- grandiosity
- needing < 3 hrs sleep
- pressured speech
- racing thoughts
- increased goal-dircted activity or psychomotor agitation
- increased dangerous pleasurable activities
What is the difference between manic episode & hypomanic episode?
hypomanic episode is not severe enough to cause impairment in social or occupational life or result in hospitalization
What are the treatmetn approaches to bi-polar disorder?
- lithium
- anti-seizure medications
- atypical antipsychotic medications
- alternative : benzodiazepine medication
What are the “big 6” of side effects seen in antipsychotics?
- acute dystonic reactoin
- akathisia
- neuroleptic malignant syndrome (NMS)
- parkinsonian-like tremor
- tardive dyskinesia
- metabolic syndrome
What are the 5 classic symptoms of metabolic syndrome?
- decreased high-density lipoprotein cholesterol (“good” cholesterol)
- elevated blood pressure
- elevated body weight (central obesity)
- elevated serum glucose
- elevated triglycerides
