Mood Disorders (Depression) Flashcards
What are risk factors for depression?
- female
- chronic disease or medical comorbidity
- family history
- prior depression
- abuse
- lack of social support
- stressful life events
- substance use
- economic difficulty
What causes depression?
- genetic factors?
- related to neurotransmitters?
- hormones?
- immune response?
What is the diagnostic criteria for major depressive disorder?
- depressed mood or loss of interest/pleasure (anhedonia) in all activities for at least two weeks
AND 4 of:
- change in appetite
- change in concentration
- change in energy
- psychomotor agitation or retardation
- excessive guilt or feelings of worthlessness
- suicidal ideation
What is dysthymic disorder?
a milder form of major depressive disorder
What nursing diagnoses might a patient with depression have?
- disturbed sleep
- imbalanced nutrition
- fatigue
- ineffective coping
- risk suicide
Other than medications, what interventions can be helpful for patients with depression?
- proper nutrition
- proper sleep
- exercise
- electroconvulsive therapy (ECT)
- phototherapy
- cognitive behavioural therapy (CBT)
What differences might you note in children who have depression?
- more likely to have irritated, instead of sad mood
- high risk of suicide
- more likely to have psychosis with auditory hallucinations
What categories of drugs are used to treat depression? List in order of preference.
- selective serotonin re-uptake inhibitors (SSRIs)
- atypical antidepressants- cyclic antidepressants
- monoamine oxidase inhibitors
What is an example of an SSRI? What does this drug do?
- sertraline (Zoloft)
- inhibit reuptake of serotonin to increase levels of serotonin
What is an example of a MAOI? What does this drug do?
- phenelzine (Nardil)
- inhibits MAO to increase neurotransmitters in CNS
What is an example of an atypical antidepressant?
- venlafaxine (Effexor)
What is an example of a cyclic antidepressant? What does this drug do?
- imipramine (Tofranil)
- inhibits reuptake of serotonin and norepinephrine
Which categories of antidepressants would you avoid giving to a patient with a higher risk of suicide and why?
avoid using cyclic antidepressants and MAOIs - they have a narrow therapeutic window
What are side effects of SSRIs?
- serotonin syndrome
What are side effects of MAOIs?
- sedation, dry mouth, constipation, weight gain
- hypertensive crisis may occur if you eat foods with tyramine (aged cheese, beer, red wine, chocolate…)
- lethal in overdose
