Psych 1 Flashcards
0
Q
What does the DSM contain?
A
Explicit diagnostic criteria in a checklist format.
Multiaxial system.
Neutral regarding etiology (except adjustment disorders and disorders induced by substances or general medical conditions)
1
Q
What is the DSM?
A
Diagnostic and Statistical Manual of Mental Disorders
2
Q
What are the criteria of Major Depressive Disorder?
A
Must have experienced 5 of the following in a single 2-week period (one of which must be either 1 or 2)
1) depressed mood most of the day, every day
2) loss of interest or pleasure in activities
3) unintentional weight loss/ gain, appetite loss/gain
4) insomnia/hypersomnia
5) psychomotor agitation / retardation
6) fatigue or loss of energy
7) feelings of worthlessness, excessive or inappropriate guilt
8) diminished ability to concentrate
9) recurrent thoughts of death, suicidal thoughts w/ or w/o plans or suicide attempt.
3
Q
What information does the DSM not include?
A
etiology and treatment
4
Q
What are the axises of the DSM’s multi-axial system?
A
I: maj. clinical syndromes and other conditions
II: personality disorders / mental retardation
III: physical disorders and other conditions relevant to understanding mental disorder
IV: psychosocial and environmental factors that could influence diagnosis / treatment / prognosis
V: Global assessment of function: 0-100 scale
5
Q
What score on DSM axis V is associated w/ inpatient admission?
A
41-50
Serious symptoms or impairment (social, occupational, school)
6
Q
What does DSM axis V score of 1-10 indicate?
A
persistant threat to self or others OR inability to maintain minimum hygeine OR serious suicidal act with expectation of death
7
Q
What are the biological factors that contribute to mental illness?
A
current physical disorders and history of physical illness
prenatal history
genetic factors
medications
8
Q
What social factors contribute to mental illness?
A
family relationships and interractions
supports and stressors
racial, religious, socioeconomic, cultural background
9
Q
What new diagnostic categories were added to DSM V?
A
Obsessive Compulsive and related
Trauma and Stressor relate
Disruptive, Conduct, and Impulse-control
10
Q
What psychological factors are considered in mental illness?
A
Experiences in infancy, childhood, adolescence, adulthood
current psychological strengths and weaknesses
11
Q
What is Akathisia?
A
Subjective feeling of muscular tension -> restlessness
Often caused by 1st gen antipsychotics
12
Q
What is Catalepsy?
A
Waxy flexibility
ex. if patient limb is positioned, patient will unconsciously keep it in that position
13
Q
What is Cataplexy?
A
Loss of muscular tone precipitated by emotion
14
Q
What is akathisia and what is a common cause?
A
A feeling of muscular tension that leads to physical restlessness
Side effect of 1st gen antipsychotic drugs
15
Q
Stereotypic movement
A
Repetitive, fixed pattern of movement (hand flapping, rocking, head banging)
-intellectual disability, autism
16
Q
Describe Expressive vs. Receptive aphasia
A
Expressive (Broca’s): motor deficit - knows what is intended, but can’t find words
Receptive (Wernicke’s): word salad - fluid, nonsensical speech. Impairment of comprehension
17
Q
What is circumstantial vs. tangential thinking?
A
Circumstantial: person eventually gets to the point, but indirectly
-overly abundant detail
Tangential: person never gets to point - derailed on a tangent
18
Q
In what context are visual hallucinations most common?
A
Organic illness - medical or substance related
19
Q
What is formication?
A
Tactile hallucination
20
Q
What are Hypnogogic and Hypnopompic hallucinations?
A
“normal” types of hallucinations
Hypnogogic: occur upon falling asleep (falling)
Hypnopompic: occur upon waking (someone in the room)
21
Q
What is the Moro reflex?
A
Infant extends limbs when startled
Gone by 4 mos
22
Q
Birth to 3 month milestones
A
Soc/ Lang: Smile to voice
Gross Motor: Improve head control, Follow past midline
23
Q
4-5 month milestones
A
Social / language: Recognize parent, Coos
Gross motor: Roll over, sit propped up
24
6-7 month milestones
Social / language: Laugh and Babble
| Gross motor: Sit unassisted, pass cube hand to hand
25
8-10 month milestones
Social / language: stranger anxiety, peek-a-boo, Moma / Dada (non-specific)
Gross Motor: Crawl, stand, Thumb finger grasp
26
12 month milestones
Social / language: Dada / Mama (specific) and first words
| gross motor: walk and drink from a cup
27
Piaget's theory of development and stages
```
Piaget: Cognitive
Birth - 24 month: sensorimotor
3-6 years: Pre-operational
8-10: Concrete operational
11-18: Formal operational
```
28
Erikson: theory of development and stages
```
Erikson: Psychosocial
Birth - 12mos: Trust vs. Mistrust
1-2 yrs: autonomy vs. shame vs. doubt
3-6 yrs: initiative vs. guilt
6-10 yrs: industry vs. inferiority
11-18 yrs: identity vs. role confusion
```
29
Freud: theory of development and stages
```
Freud: psychosexual
Birth -12mos: oral
1-2 yrs: anal
3-6 yrs: phallic
6-10 yrs: latency
11-18 yrs: adolescence
```
30
When in development is gender identity established?
Starts around 18 months, established by 24-30 mos.
31
When in development does object permanence develop and what is it?
Before 24 mos (part of Piaget's Cognitive model - Sensorimotor stage)
When object disappears, child knows it still exists and will look for it.
32
What occurs in Freud's phallic phase?
3-5 yrs
Genital focus
Preoccupation w/ illness and injury
Oedipal complex: focus on parent of opposite sex, competes w/ other parent for attention
33
At what point does a child understand death as final?
8 yrs. Prior to this, the concept of finality is not present. May understand that a person is "gone," but expects return.
34
What is IQ? Mean IQ? Standard Deviation? Mental Retardation?
IQ is an objective intelligence test calculation
Mean is 100 w/ Standard deviation of 15
Mental Retardation is <70 (2 std. deviations below the mean)
35
At what stage of what theory of development do the concepts of conservation and reversibility emerge?
Concrete Operations (age 6-11) of Piaget's Cognitive model
Conservation: volume remains the same in different size containers
Reversibility: water and ice are interchangeable
36
What is Freud's Latency period?
age 6-11
| Sexuality is repressed in favor of making same-sex friendships and participating in school and sport.
37
What is Industry vs. Inferiority?
Part of Erikson's Psychosocial model. Age 5-13.
Understand's family's role in larger society.
Industry: strives for sense of accomplishment, sense of mastery over environment.
Inferiority: when can't master a task
38
What is the leading cause of death in adolescents?
Accidents
| - risky behavior, sense of indestructibility
39
The stages of early and middle adulthood include what age ranges?
Early: 20-40
Middle: 40-65
40
What is Erikson's early adulthood stage?
Intimacy vs. Isolation (21-40)
Intimacy: must be able to make/honor commitments, sacrifice, and compromise
Without Intimacy -> Isolation -> withdrawal and depression
41
What is Erikson's stage of middle adulthood and what ages does it include?
Generativity vs. Stagnation, 40-60
Generativity: provide guidance to next generation
Stagnation: no impulse to guide - unprepared for old age
42
What physical changes come with middle adulthood?
Decline in biological and physiological function
Medical illness (HTN, MI, Cancer)
Menopause
Change in physical appearance (wrinkles, obesity, balding)
43
What life period does phychiatric illness usually manifest?
Young adulthood - most are chronic
Bipolar 30
Major Depression 40
Schizo men 10-25, women 25-35 (women have 2nd peak in middle age)
44
What are the most common reasons for mortality in young adulthood?
```
MVC
Homicide
Suicide
Other injury
Mental illness is a major risk factor for all!!
```
45
Cohorts in The Study of Adult Development
Privelaged males - Harvard grads born ~1920
Inner City males - socially disadvantaged born ~1930
Middle class, intellectually gifted women born ~1910
46
In the Study of Adult Development, what distinguishes Happy-Well from Sad-Sick?
```
No objective physical disability at 75
Subjective physical health at 75
Longer length of undisabled life
Mental health
Social support
```
47
How does sleep change in old age?
Decreased: Total sleep time, REM %, Stages 3 and 4 sleep
Increased: Sleep latency and nightly awakenings
48
What aspects of pharmacy does aging affect?
Volume of Distribution
Elimination half-life
NO EFFECT ON ABSORPTION
49
3 Unipolar disorders
Major Depressive Disorder
Dysthymic disorder
Depressive Disorder NOS
50
What is a Dexamethasone test?
Given to a patient with depression or suspected depression - Dexamethasone is synthetic cortisone
In non-depressed patients, glucocorticoid synthesis is suppressed.
In depressed patients it is not (50% of pts w/ MDD)
Indicates increased liklihood of melancholia, psychotic features, and suicide.
51
What is the monoamine theory of depression?
Depression is result of dysregulation of monoamines:
Serotonin: people who committed suicide have low levels in CSF and low numbers of platelet uptake sites on platelets.
--Indirect evidence: SSRIs are effective
Norepinepherine: correlation between downregulation of B-adrenergic receptors and reponse to SNRIs
Dopamine: Drugs that decrease DA may induce depression. Drugs that increase DA help treat
52
At what point in development do gender differences in depression manifest?
Puberty
53
What gene polymorphism is linked to depression and SSRI response?
5-HTT : serotonin transporter
| Ask what meds have worked for family members - likely to work for patient.
54
What does acute phase treatment for MDD consist of?
Usually 6-8 weeks w/ 2x monthly visits to monitor symptoms, medication adherence, side effects, dose adj, etc.
Antidepressants should be switched if no clear effect in 4-6 weeks
55
What is the continuation phase of MDD treatment?
After acute phase / pharmacotherapy : 6mos - 1 year of treatment to prevent relapse and ensure remission.
56
What is Dysthymia?
Less severe than MDD
Patients are depressed + 2 of:
CHASES: Concentration, Hopeless, Appetite, Sleep, Energy, Self Esteem
Symptoms most days for 2+ years (children and adolescents 1yr)
57
What symptoms are missing in Dysthymia compared to MDD?
Anhedonia, Guilt / Worthessness, Psychomotor abnormality, suicidal ideation.
58
What is premenstrual dysphoric disorder?
Similar to MDD symptoms associated with menstrual cycle. Symptoms present with almost every cycle with last week of luteal phase, remitting shortly after menstrution begins.
59
How is PMDD treated?
SSRI first line pharmacotherapy (luteal vs. full cycle: no diff)
also: lifestyle: exercise, diet (decrease sodium and caffeine)
vitamin B6, E, Ca, Mg
60
Define a manic episode
Persistently elevated, expansive, or elavated mood lasting 1 week or more plus 3 of the following (4 if only irritable)
DIG FAST
Distractability, Indiscretion, Grandiosity, Flight of Ideas, Activity Increase, Sleep deficit, Talkativeness
Impaired functioning may -> psychosis
61
What is hypomanic disorder?
Same as manic, but shorter lived. 4 days vs. one week.
Change in function, no impairment, no psychosis
62
What is a mixed episode?
Criteria for both MDD and Manic episode are both met (except duration) EVERY DAY for 1 week
63
What is BPAD and how are types I and II defined?
Bipolar Affective Disorder
Type I: requires one manic episode (MDE common (80-90%), not a requirement)
Type II: must have both hypomanic and MDE w/ no history of mania or mixed episodes. Significant imparement due to MDE
64
At what age does BPAD usually manifest?
BPAD-I: 18
BPAD-II: 20
if first manic episode at 40+ start medical work-up
65
Enlarged 3rd ventricle is the most common imaging finding of what disorder?
BPAD
66
What is the prognosis for BPAD I?
Worse than MDD
50-60% achieve control w/ mood stabilizers
20-30% do not remit to baseline
30% have significant social decline
67
What is the prognosis for BPAD II?
Not well studied
Chronicity
5-15% -> BPAD I
68
What is appropriate pharmacotherapy for BPAD I?
Lithium, Valproic Acid, Atypical and Typical antipsychotics
May need sedative for manic disorders - benzidiazapine or antypsychotic
69
What is cyclothymia?
For 2 yrs: presence of multiple periods of hypomania and non-MDE depressive symptoms
Cannot be w/o symptoms for >2 mos.
Clinically significant distress / impairment.
70
What is adjustment disorder w/ depressed mood?
Depressive symptoms w/in 3 months of identifiable stressor
Impairment in function. Does not meet other criteria, does not meet criteria fore bereavement.
Symptoms resolve w/in 6 mos post-stressor.
71
Depression commonly precedes the diagnosis of what major illness?
Pancreatic cancer.
72
Criteria for substance induced mood disorder
Symptoms during or w/in one month of intoxication or withdrawal.
If pre-existing history of recurrent mood disorder or if symptoms persist for > 1 month post - likely primary mood disorder.
73
What are catatonic features?
Immobility, purposeless activity, negativism, mutism, posturing, stereotypies, echolalia, echopraxia
74
What substances are associated with mania?
Cocaine/Amphetamines
Stimulants
L-Dopa
Antidepressants
75
Specifiers for mood disorder with Peripartum Onset
Symptoms w/in 4 weeks of delivery
| Major Depressive, Mania, Mixed
76
What is rapid cycling in mood disorder?
at least 4 episodes of depressive, manic,hypomanic, or mixed within a 12 month period.
5-15% w/ BPAD
> in women
77
What must be demonstrated before prescribing antidepressants?
Clinically significant distress or impairment of social, occupational or other important areas of functioning.
78
In patients w/ significan comorbid anxiety what drug should be avoided?
Bupropion
79
What drug treatment is recommended for depression patients w/ significant anxiety?
Antidepressant w/ benzodiazepine (endpoint in mind - use for 1st month while acclimating to antidepressant)
80
How long does it take for full response to antidepressant therapy? Why?
may be improvement in 1-2 weeks
| Need to wait 4-8 weeks to fully asses response. Treatment results in downregulation of receptors - takes time.
81
What is the #1 risk factor for recurrence of depressive symptoms after treatment?
Patient being initially treated to RESPONSE rather than REMISSION.
82
How should antidepressants be discontinued?
Taper over weeks.
May have to switch to longer half-life drug.
Plan for event of relapse
Monitor
83
Does an increased blood level of SSRI increase liklihood of response?
No.
| Increased drug level does not improve probability of response
84
What SSRI has the longest half-life? How long?
Fluoxetine
| T1/2 = 7-10 days (active metabolite)
85
What are side effects of SSRIs?
* side-effects generally not expected @ normal dosing*
- GI distress: N/V/D (if persistent diarrhea - change drugs)
- Migraine / Tension headache exacerbation (transient)
- Sexual dysfunction, decreased libido (ejac. dysfunction, anorgasmia) - can lower dose and add bupropion
- Weight change - esp. Paroxetine (gain)
- Insomnia - Fluoxetine
- Sedation - Paroxetine
86
How are SSRIs metabolized?
All in liver, P450 (inhibition of CYP2D6)
Citalopram, Escitalopram, and Sertraline have fewest P450 interactions.
Fluvoxamine has most interactions.
Fluoxetine and Paroxetine interfere w/ opiates (prevent conversion to active form)
87
What side effects are seen with SNRIs?
Same as SSRI (GI, Sexual, activation)
with addition of NE related
-dose dep. HTN, increased HR, sweat, dry mouth, constipation, dilated pupils
88
What are some reasons for using Bupropion? When should it not be used and what are major risks?
Smoking cessation
No serotonergic activity: no sexual dysfunction (may improve sexual function)
Minimal weight changes
Not useful as anxiolytic
Seizure risk in high doses (above FDA dose of 450 mg)
Do not use in bulemic patients - electrolyte imbalance
89
What are side effects of Mirtazapine?
```
Sedation at LOW doses
Weight gain (anti-histamine)
Less impact on sexual function than SSRI and SNRI
```
90
What is Vilazadone's MOA?
SSRI + 5-HT1A agonism
Has more GI side effects than other SSRIs
supposedly fewer sexual side effects, but flawed study - looked at patients w/ depression related SD
91
What is Trazadone used for? Side effects?
Infrequently used as antidepressant. Used for insomnia.
SSRI + 5-HT2 agonist
Higher doses - orthostatic hypotension and priapism
92
What is the TCA MOA?
Block NET and SERT - SNRI like activity
Antagonize a1, histamine, muscarinic Ach receptors
-potentially fatal in OD
93
What are TCAs used for?
Depression
| Migraine, neuropathies, enuresis, trigeminal neuralgia
94
What are TCA side effects?
Antihistamine: weight gain, sedation
Antiadrenergic: orthostatic hypotension, dizziness
Anticholinergic: dry mouth, constipation, urinary hesitancy, blurred vision, agg. narrow angle glaucoma, sedation
Cardiac (Na+ channels): tachycardia, flat T wave, QT prolong, depress ST
- - baseline EKG if over 40 or cardiac hx
- - no subsequent monitoring unless new symptoms
95
What is the physiological distribution of MAOs?
MAO-A and -B in brain
| MAO-A major MAO outside of the brain
96
How can MAOi use result in hypertensive crisis? How is it treated?
MAO-A inhibition can -> tyramine induced NE released in gut -> HTN
treated with alpha-antagonist: phentolamine
97
What is the 2 week rule of antidepressants?
Must wait 2 weeks before administering a restricted drug (interactions) or eating a restricted food.
Exception: fluoxetine - long half-life - must wait 5 weeks to start MAOi after stopping fluoxetine
98
What is electroconvulsive therapy recommended for?
Drug resistant MDD, bipolar, or acute onset schizophrenia
- -2+ medication failures
- -acute suicidality
70% response in treatment-resistant patients.
99
How should Lithium levels be monitored in patient? What is the range of therapeutic concentrations?
0.6-1.2 mEq/L
Draw 12 hrs. after last dose.
Check at start of treatment, then every 3-4 months until stable, then every 6 months.
100
What is Ebstein's Anomoly and what is it associated with?
Tricuspid valve is licated toward apex of RV. May be ASD present.
Associated with Lithium used in first trimester of preg.
101
What are the 3 levels of consciousness in the topographic theory of the mind?
Conscious: what you are aware of
Preconscious: can become aware w/ effort
Unconscious: can not become aware of - still influential
102
How is the topographic model inadequate?
Does not address reasons behind symptoms and treatment
103
What are the elements of the structural model?
Ego: conscious and unconscious aspects. Moderates Id and Superego. Descision making.
Id: completely unconscious. Sex and Aggression.
Superego: mostly unconscious. conscience and values.
104
What is transferrance? Countertransferrance?
Unconscious redirection of feelings/ desires from the past toward the therapist.
Countertransferrence: reverse - therapist projects feelings toward patient
105
What is psychodyanamic therapy?
based on Freud's theory of uncovering unconscious aspects of patient's life leading to greater self-understanding
Focus on: unconscious conflicts, repressed feelings, family issues from early life, difficulty w/ current relationships
106
What is psychoanalysis?
Most intensive and rigorous form of psychotherapy.
3-6 sessions / week
Treated by psychoanalyst
pt. on couch, therapist behind
107
What is behavioral therapy?
Use of classical and operant conditioning to directly change maladaptive behavior.
Improve symptoms w/o focusing on underlying history
108
What are the 3 main parts of systematic desensitization?
Relaxation: learn techniques
Heiarchy: establish heiarchy of anxiety provoking stim.
Desensitization: apply relaxation to imagined scenes in therapy sessions
109
Graded exposure vs. systematic desensitization
Systematic desensitization: walk through imagined scenes in therapy
Graded exposure: same system, but practiced in real life. Patient has "homework"
110
Flooding vs. Implosion therapy
Flooding: patient is exposed to real-life stimulus w/o ability to escape - belief that escape contributes to anxiety. W/o escape, patient sees that situation is survivable and fear decreases.
Implosion: same idea, but imagined in setting of therapy.
111
Describe Cognitive Behavioral Therapy
Combines Cognitive and Behavioral therapy
Psychopathology is the product of distorted thinking which negatively impacts behavior and mood.
Collaborative, goal oriented.
Cognitive: recognize, discuss, challenge automatic thoughts
Behavioral: apply relaxation techniques, graded exposure, etc.
112
What is dialectical behavioral therapy?
Specific to treatment of Borderline Personality Disorder
Individual + group therapy.
Patients seen weekly for about a year
goals:
Reduce self-destructive / injurious behavior
Improve interpersonal skills
113
What does "psychotic" mean?
Hallucinaton
Delusion
Disorganized speech and behavior
114
What is the cause of positive psychotic symptoms?
Malfunction in mesolimbic system
115
What is the cause of negative symptoms?
Defect in Mesocortical or prefrontal cortical.
| Problem with nucleus acumbens reward pathway likely
116
What does schizophrenia consist of?
2 or more of the following for 1 month:
Hallucination
Delusion
Disorganized speech
Grossly disorganized or catatonic behavior
Negative symptoms
Or only 1 if bizarre delusions, continuous commentary hallucinations, 2 or more voiceds conversing
117
How does NMDA hypofunction explain schizophrenic symptoms?
In mesolimbic path: Glutamate -> NMDA -> GABA -> inhibit DA release
in schizo: NMDA does not inhibit DA: elevated DA -> (+) symptoms
Mesocortical path: No GABA interneurons! Glutamate -> NMDA -> DA release
schizo: Glutamate -> NMDA -> decreased DA release -> (-) symptoms
118
What is schizophreniform?
Same criteria as Schizophrenia, but only 1-6 mos.
Most go on to Schizophrenia.
Does not require decline in functioning, though it may be present.
119
Describe schizoaffective disorder
```
Schizo symptoms (2+ for 1 month) + mood disorder
preceeded or followed by 2 weeks of delusions or hallucinations w/o mood disorder
```
120
what constitutes deusional disorder?
1 month of non-bizarre delusions
No marked impairment of judgement or function
Normal behavior.
121
What are the treatments for EPS in patients on antipsychotic therapy? (Parkinsonism, Acute dystonia, Akathisia)
Parkinsonism: PO anticholinergic - Benztropine
Acute dystonia: IM or IV anticholinergic - Benadryl
-once stable, PO Benztropine
Akathisia: Beta blocker, Benzodiazapine, Anticholinergic
122
In patients taking antipsychotics, what causes tardive dyskinesia?
Chronic DA blockade -> upregulation of receptors
| Takes >6 mos. to develop, irreversible
123
What symptoms accompany increased prolactin in patients on antipsychotics?
Galactorrhea, amenorrhea, poor fertility, sexual dysfunction, demineralization of bone.
124
What is Neuroleptic Malignant Syndrome?
Potentially fatal side effect of antipsychotics
Muscle rigidity, hyperthermia, diaphoresis, dysphagia, tremor, incontinence, altered consciousness, mutism, tachycardia, elevated or labile BP
125
How is NMS treated?
Neuroleptic Malignant Syndrome
- Dantrolene
- DA agonist
126
What is the effective treatment for drug-resistant schizophrenia?
Clozapine - atypical antipsychotic
Used when failure of 2+ other drugs.
Risk: agranulocytosis
Also - weight gain, diabetes, myocarditis
127
How is clozapine use monitored?
CBC every week for 6mos, then every 2 weeks.
128
What did the CATIE study reveal about antipsychotics?
Olanzapine most effective despite side effects
| Perphenazine (mid-potency typical) as effective as atypicals except olanzapine
129
What part of brain is particularly associated w/ anxiety disorder?
Amygdala
Basal nucleus -> coping
Central nucleus -> passive fear (anxiety)
130
What is the basis of the neurochemical model of anxiety?
NE, 5-HT and GABA antagonist administration can induce panic attacks
NE and 5-HT neurons promect to limbic cortex - implicated in anxiety
Benzodiazepine efficacy (via GABA potentiation) - supports idea.
131
What medical disorders need to be ruled out before diagnosing anxiety?
cardiomyopathy
endocrinopathy
respiratory disease
132
What medications are associated with casuing anxiety?
Beta blocker withdrawal
| corticosteroids
133
What drug is most effective for panic disorder?
Paroxetine
| SSRI
134
What drugs are useful for treating social phobia disorder?
Paroxetine
Beta blockers - for specific performance anxiety situations
Benzodiazepines - not useful for comorbid depression. Care in pts. w/ drug/alcohol use
135
PTSD criteria and symptoms
Traumatic event must involve death, serious injury, or threat.
Reaction must include intense fear, helplessness or horror.
Re-experiencing
Avoidance of stimuli assoc. with trauma and numbing of general responsiveness
Persistent increased arousal.
136
What is treatment for PTSD?
Anxiety mgt
Antidepressant
Psychotherapy
Lifetstyle mgt.
137
What is first line treatment for anxiety disorders?
SSRI, but not bupropion
138
What benzodiazepines avoid liver metabolism?
Oxazepam
Temazepam
Lorazepam
Metabolized by glucoronidation only - not microsomal oxidation
Good for liver disease and elderly patients
139
What is treatment for insomnia?
Meds are not first line therapy
First: Review underlying causes - mental illness, medication
Consider sleep hygeine
140
What medications may be used to treat insomnia?
Benzodiazepines - short term use.
decreases time to sleep onset, increases duration of sleep.
may experience rebound insomnia upon withdrawal - taper meds.
Non-benzo receptor agonists (Zolpidem, Zaleplon, Eszopliclone)
-lack other benzo properties, retain sedative-hypnotic effect.
