Mood disorders Flashcards
What is the most appropriate antidepressant to prescribe following an MI
Setraline
antidepressant of choice if required in children/adolescents
fluoxetine
why are MAOIs not routinely used?
what are they reserved for?
they can cause hypertensive crisis if you dont stick to strict dietary requirements (no tyramine containing foods)
Reserved for atypical depression
tx of hypertensive crisis
alpha blockade
adverse effects of SSRIs
sexual dysfunction, short term anxiety..
which antidepressants can have adverse effects on cardiac function?
TCAs
BZD overdose, antagonist?
flumazenil
1st line drug tx for anxiety
BZD but recommended short term to avoid dependence
Endocrine changes in major depression
^ CRH in CSF
^ secretion of cortisol
»» hippocampus SHRINKS in response to cortisol, and the hippocampus is essential in short term memory function
enlarged adrenal glands
50-70% fail to suppress cortisol following dexamethasone
^TRH in CSF
atypical depression features
mood reactivity significant weight gain hypersomnia leaden paralysis interpersonal rejection sensitivity
waking > 2 hrs before usual, depression worse in morning, loss of appetite etc… is a feature of ?
somatic syndrome
Hypomanic episode - abnormally elevated/irritable mood for how long?
more than or equal to 4 days
manic episode - sustained for how long?
more than or equal to a week
True or False: 1/3 of sufferers of panic disorder develop agoraphobia
false, 2/3!!!!
What percentage of those with social phobia abuse alcohol
20%
1st line medical tx of GAD
SSRIs
OCD - symptoms have to be occurring for ??
over an hour per day
38% of obsessions in OCD are related to ?
dust. germs ..
is heritability high or low in OCD?
high
1st line tx in OCD
exposure and response prevention (ERP)
what is the desired effect of antipsychotics
DA blockade in the mesolimbic circuits
Bipolar 1 - has to have met criteria for ?
mania
bipolar 2
never met manic criteria
but its NOT a milder form!!
bipolar 3
hypomanic episode only occurs following antidepressants
does a single episode of hypomania/mania class as bipolar disorder?
yes, even if you have net been depressed yet
what do most sufferers of panic disorder develop
agoraphobia
1st line OCD tx
exposure and response prevention (ERP) - highly effective in OCD
multiple recurrent and frequently changing physical symptoms
somatisisation
deliberately producing false symptoms
factitious disorder
% of non epileptic attack disorder that actually have epilepsy
10%
feigning illness for secondary gain
malingering
Cluster A personality disorders
“weird”
- schizoid (aloof)
- schizotypical (awkward)
- paranoid (accusatory)
Cluster B personality disorders
“wild”
- borderline
- antisocial (bad)
- histrionic (bullshit)
- narcissistic (best)
Cluster C personality disorders
“worried:
- avoidant (coward)
- obsessive-compulsive (compulsive)
- dependent (clingy)
first line drug treatment for panic disorder
SSRI
conversion disorder
typically involves loss of motor or sensory function (may seem to be a stroke)
patient does NOT consciously feign the symptoms
dissociative disorder
psych symptoms - amnesia, stupor, fugue (forgetting personal identity, memories etc)
