physiologic therapies

Question 1

phototherapy - I

Answer 1

1st line for SAD
dep with pregnancy

Question 2

phototherapy

Answer 2

light influences melatonin and serotonin in pineal gland
UV protection, dont look directly into, 30-45 min/day (2-3x/wk)
safe

Question 3

phototherapy - SE

Answer 3

HA, jitteriness, eye strain, n, sweat, sedation
can trigger mania or hypomania -> make sure not bipolar

Question 4

ect

Answer 4

non invasive (pt not conscious, paralytic drug -> compression fracture of spine)

Question 5

ect - I

Answer 5

most effective dep tm -> esp with severe malN, exhaustion, dehyd (rehyd before)
psychotic illnesses
delusional dep
failure of previos med trials (several) -> refractory dep (not first line)
schizophrenia with catatonia

Question 6

ect - process

Answer 6

anesthesia and muscle relaxant
electricity (<1s) applied to temporal region, induce brief seizure (30-60s), wake up 15 min after, unilateral v bilateral electrodes
2-3/wk, 6-12 total
not exactly sure how it works -> alter NT receptors, increase serotonin, stress hormone regulation, increase cerebral BF -> neurogenesis
can use w or w/o meds

Question 7

ect - SE

Answer 7

safer than meds with certain conditions, avoid polypharm (esp elderly)
stress on heart at seizure onset and 10 min after: htn (manage), congestive HF, arrythmias, other conditions
stress brain as result of increased cerebral oxygen, BF, increase ICP: CI in brain tumor and subdural hematoma
confused and disoriented for several hours -> freq reorient
retrograde amnesia -> loss of mem of events leading up to treatment

Question 8

transcranial magnetic stim

Answer 8

noninvasive, MRI strength magnetic pulses stim focal areas of cerebral cortex, awake and alert, neurons fire
no neuro deficits or mem problems
I: dep resistant to tm
5/wk for 4-6 wk, out pt

Question 9

transcranial magnetic stim: SE

Answer 9

CI: metal, pacemaker, hx seizure
HA, lightheaded, seizures rare, scalp tingling and discomfort at site, jaw tighten, head knocking/tap

Question 10

vagus nerve stim

Answer 10

invasive, electric stim boosts NT levels by activating limbic system, 30s q5 min
I: epilepsy, decrease seizures, increase mood, resistant dep
SE: voice change, HA, neck pain, cough, paresthesia, dyspnea -> dec with time

Question 11

deep brain stim

Answer 11

most invasive, 2 electrodes in brian
I: PD, dep -> stim underactive regions

Question 12

exercise

Answer 12

better in nature
biological, social, psychological effects
dec HPA axis -> overly active in dep
change in serotinin, dopamine, norepi levels
cheaper, less SE

Question 13

herbal

Answer 13

not reg by FDA, [] not consistent

Question 14

herbal - st johns wort

Answer 14

flower -> tea, tablets
inc serotonin, norepi, dopamine
mild - mod dep

Question 15

herbal - ginseng

Answer 15

stress and fatigue

Question 16

herbal - valerian root or chamomile

Answer 16

insomnia, dep, stress / anx

Question 17

herbal - samE

Answer 17

dep

Question 18

misc

Answer 18

pet therapy (PTSD, autism), aroma therapy (topic, inhaled, diffuse; smell connects with ANS), acupuncture/pressure (cravings and substance abuse)
increase mood and decrease anx