mood disorders Flashcards
What are the side effects of SSRIs?
- headache
- GI disturbance [n/v/diarrhea]
- sexual dysfunction
- rebound anxiety
What is the most lethal class of mood disorder drugs for overdose?
TCAs
What are the side effects of TCAs?
- orthostatic hypotension
- sedation
- weight gain
- prolonged QT syndrome
- anticholinergic side effects
What is the most common side effect of MAOIs?
orthostatic hypotension
What are the 3 hallmarks of 5HT syndrome?
- hyperthermia
- autonomic instability
- seizures
What can be an adjunct medication for patients with depression who are terminally ill or who have refractory symptoms?
stimulants [methylphenidate]
What class of drugs is used to treat “atypical depression”?
MAOIs
What are the three main situations when you would use ECT to treat depression?
- unresponsive to pharmacotherapy
- not tolerate pharmacotherapy [pregnancy]
- rapid reduction of symptoms [high suicide risk]
What is the main side effect of ECT?
Retrograde and anterograde amnesia but usually it disappears after 6 months
[other side effects: headache, nausea, muscle soreness]
What are characteristics of atypical depression?
hyperphagia hypersomnia reactive mood leaden paralysis sensitivity interpersonal rejection
What are the 5 Kubler Ross Stages of grief?
1. denial 2, anger 3. bargaining 4. depression 5. acceptance
What is meant by “rapid cycling” for bipolar patients?
What drug best treats “rapid cyclers”?
4 or more mood episodes in 1 year
-treated best with carbamazepine
How long do untreated manic episodes usually last?
3 months
What are the major side effects of lithium?
weight gain tremor GI disturbances cardiac arrhythmia seizures leukocytosis polyuria [nephrogenic diabetes insipidus] metallic taste hypothyroidism
What is the effect of lithium, carbamazepine and valporic acid on suicide risk for bipolar patients?
lithium decreases suicide risk
carbamazepine and v.a. increase the suicide risk
What 3 types of psychotherapy work best for bipolar one?
- supportive
- group
- family
What are the 5 main symptoms of dysthymic disorder?
CHASES
- concentration is poor
- hopeless feeling
- appetite is too little or too much
- sleep
- energy
- low self -esteem
2years, never 2 months w/o symptoms, atleast 2 symptoms
What personality disorder may coexist with cyclothymic disorder?
borderline
What percent of patients with cyclothymia are eventually diagnosed with bipolar?
33%
What is the triad for seasonal affective disorder?
irritability
hypersomnia
carbohydrates cravings
What is the time criteria for adjustment disorder?
maladaptive behavior must occur within 3months of the event and last no more than 6 months
What is the most effective treatment for adjustment disorder?
supportive psychotherapy
