mood disorders

Question 1

What are the side effects of SSRIs?

Answer 1

1. headache
2. GI disturbance [n/v/diarrhea]
3. sexual dysfunction
4. rebound anxiety

Question 2

What is the most lethal class of mood disorder drugs for overdose?

Answer 2

TCAs

Question 3

What are the side effects of TCAs?

Answer 3

1. orthostatic hypotension
2. sedation
3. weight gain
4. prolonged QT syndrome
5. anticholinergic side effects

Question 4

What is the most common side effect of MAOIs?

Answer 4

orthostatic hypotension

Question 5

What are the 3 hallmarks of 5HT syndrome?

Answer 5

1. hyperthermia
2. autonomic instability
3. seizures

Question 6

What can be an adjunct medication for patients with depression who are terminally ill or who have refractory symptoms?

Answer 6

stimulants [methylphenidate]

Question 7

What class of drugs is used to treat “atypical depression”?

Answer 7

MAOIs

Question 8

What are the three main situations when you would use ECT to treat depression?

Answer 8

1. unresponsive to pharmacotherapy
2. not tolerate pharmacotherapy [pregnancy]
3. rapid reduction of symptoms [high suicide risk]

Question 9

What is the main side effect of ECT?

Answer 9

Retrograde and anterograde amnesia but usually it disappears after 6 months

[other side effects: headache, nausea, muscle soreness]

Question 10

What are characteristics of atypical depression?

Answer 10

hyperphagia
hypersomnia
reactive mood 
leaden paralysis
sensitivity interpersonal rejection

Question 11

What are the 5 Kubler Ross Stages of grief?

Answer 11

1. denial
2, anger
3. bargaining
4. depression
5. acceptance

Question 12

What is meant by “rapid cycling” for bipolar patients?

What drug best treats “rapid cyclers”?

Answer 12

4 or more mood episodes in 1 year

-treated best with carbamazepine

Question 13

How long do untreated manic episodes usually last?

Answer 13

3 months

Question 14

What are the major side effects of lithium?

Answer 14

weight gain
tremor
GI disturbances
cardiac arrhythmia
seizures
leukocytosis 
polyuria [nephrogenic diabetes insipidus]
metallic taste
hypothyroidism

Question 15

What is the effect of lithium, carbamazepine and valporic acid on suicide risk for bipolar patients?

Answer 15

lithium decreases suicide risk

carbamazepine and v.a. increase the suicide risk

Question 16

What 3 types of psychotherapy work best for bipolar one?

Answer 16

1. supportive
2. group
3. family

Question 17

What are the 5 main symptoms of dysthymic disorder?

Answer 17

CHASES

1. concentration is poor
2. hopeless feeling
3. appetite is too little or too much
4. sleep
5. energy
6. low self -esteem

2years, never 2 months w/o symptoms, atleast 2 symptoms

Question 18

What personality disorder may coexist with cyclothymic disorder?

Answer 18

borderline

Question 19

What percent of patients with cyclothymia are eventually diagnosed with bipolar?

Answer 19

33%

Question 20

What is the triad for seasonal affective disorder?

Answer 20

irritability
hypersomnia
carbohydrates cravings

Question 21

What is the time criteria for adjustment disorder?

Answer 21

maladaptive behavior must occur within 3months of the event and last no more than 6 months

Question 22

What is the most effective treatment for adjustment disorder?

Answer 22

supportive psychotherapy