Mood disorders Flashcards
What are the core features of a depressive mood disorder?
- > 2 weeks & unusual for the individual
- Loss of interest or pleasure in activities that are usually pleasurable
- Decreased energy
What are the additional symptoms for a depressive illness?
Loss of confidence Suicidal behaviour Agitation or retardation Change in appetite Guilt Loss of concentration Sleep disturbance
How does atypical depression present?
Mood reactivity (brightens in response to positive)
Weight gain/increased appetite
Hypersomnia
Leaden paralysis
Long standing interpersonal rejection sensitivity
When are lithium levels measured?
12 hours post dose
Describe a hypomanic episode
Elevated or irritable mood for at least 4 day
+ 3 of the following:
- increased activity/restlessness
- difficulty concentrating
- decreased need for sleep
- increased sexual activity
- mild spending sprees/reckless behaviour
Describe a manic episode
Elevated or irritable mood for at least 1 week
+ 3 of the following
- Increased physical activity/restlessness
- increased talkativeness (‘pressure of speech’)
- Flight of ideas/thought racing
- Loss of social inhibitions
- decreased need for sleep
- inflated self esteem/grandiosity
- Distractibility or constant change in plans
- Unrecognised reckless behaviour
- marked sexual energy or indiscresion
What is present in a manic episode that isn’t in a hypomanic episode?
Manic = at least a week (compared to 4 days) Loss of ocial inhibitions Pressure of speech Flight of ideas/thought racing UNRECOGNISED reckless behaviour Grandiosity
What is the difference between Bipolar I & Bipolar II?
Bipolar I = met criteria for mania, classic form of “manic-depressive psychosis”
Bipolar II = current or past hypomanic & depressive episode, has never met criteria for mania
Which is more common Bipolar I or Bipolar II?
Bipolar II
What is the treatment for a aggitated hospitalized bipolar patient?
IM olanzapine
What is the treatment for manic predominant bipolar?
Lithium
What is the treatment for depression dominant bipolar?
Lamotrigine
What is the treatment for acute depression in a bipolar patient?
Olanzapine + fluoxetine
Which bipolar medication decreases the effectiveness of the OCP?
Lamotrigine
