Mood Disorders Flashcards
3 core symtpoms of unipolar depression
Persistent low mood
Anhedonia
Anergia
Non core symptoms of depression to screen for
Sleep disturbance
Weight loss or gain
Appetite change
Reduced concentration
Feelings of guilt or hopelessness
Mild moderate and severe depression classification
Mild - 2 core and 2 other
Moderate- 2 core and 4 others
Severe - 3 core symptoms with 5 other
SSRI of choice in adolescence
Fluoxetine- review in one week if <30
Treatment course of choice in unipolar depression
SSRI - SSRI - SNRI
Pharmacological managment of psychotic depression
Anti depressant with rapid increase in dose
Augment with oral anti psychotic (quetiapine, olanzapine)
Indications for ECT
Treatment refractory depression
Psychotic depression
Catatonia
How long do symptoms of depression have to be present
2 weeks
What two questionaires are used to screen depression
HAD - 14 questions scored 0-3.
0-7 normal 8-10 borderline 11+ depressive episode
PHQ-9- 9 questions scored 0-3
5-9 mild 10-14 moderate 15-19 moderately severe 20+ severe
Diagnostic criteria for manic episode
Elevated mood, increased energy, causing over activity pressure of speech and reduced need for sleep
Lasts for one week, impairs patient function
Pharmacological treatment of acute mania
Discontinue any antidepressant
Initiate oral anti-psychotic : olanzapine or quetiapine
May need depot
Consider Benzo and Z drug
Diagnostic criteria of bipolar depression
At least two episodes, one of which must be manic, hypo,antic or mixed, with recovery between.
Definition of hypomania
Lasts 4 days
Similar to to mania but does not markedly impair patient function
Prophylaxis of bipolar disorder
Consider mood stabiliser after resolution of manic episode
Lithium carbonate or depakote
Depakot MUST be avoided in women of child bearing potential
Carbamazepine second line
Pharmacological treatment of bipolar depression
Olanzapine and fluoxetine
