Ott Depression Flashcards
risk of reoccurrence with 1 episode
2 episodes
3 episodes
50-60%
70%
90%
risk of recurrence over time
decreases as the duration of remission increases
(longer time in remission = decreased risk)
predictor of recurrence?
persistent mild symptoms during remission
at least one sx must be what for depression dx?
depressed mood or loss of interest/pleasure in doing things
depression diagnostic mnemonic
SIGE CAPS
sleep
interest decreased
guilt / worthlessness
energy loss
concentration
appetite changes
psychomotor agitation
suicidal
what rating scale screens for depression?
PHQ-9
which rating scale is used to rule out bipolar?
MDQ (mood disorder questionaire)
4 goals of depression treatment
reduce / eliminate signs
restore functioning to baseline
reduce risk of relapse
reduce risk of suicide
Box warning for antidepressants
suicidal ideation in all pts 24 or younger
(counsel them all)
which med has QTC prolongation?
citalopram
citalopram substrate
2C19 and 3A4
fluoxetine CYPs
2D6 inhibitor
3A4 inhibitor (norfluoxetine) (active metabolite)
which drug has activating potential?
fluoxetine
take in morning
which SSRI is the longest acting?
fluoxetine (96-144 hours)
fluvoxamine CYPs
inhibitor 1A2
inhibitor 2C19
paroxetine CYPs
inhibitor 2D6
inhibitor 2B6
which SSRi is the hardest to stop?
paroxetine, anticholinergic effects
paroxetine side effects
weight gain, sedation (take at night)
which drug has septal wall defect risk
paroxetine
sertraline side effect
more GI / nausea effect than others
which SSRI is weight gain
paroxetine
which SSRI is weight loss
fluoxetine
adverse effects of SSRIs
sexual dysfunction
hyponatremia (in elderly)
increased bleeding risk (platelet inhibition)
active metabolite of venlafaxine
desvenlafaxine
desvenlafaxine CYPS
none :)
side effect of desvenlafaxine
nasua: dose limiting
which drug has FDA warning for hepatotoxicity
duloxetine
duloxetine CYP
inhibitor 2D6