Psych Flashcards
Mx of PTSD?
Watchful waiting
Trauma-CBT / EMDR
If not tolerated SSRI / Venlaflaxine / Risperidone (v severe)
How long to continue antidepressants for after resolution of sx?
6 months
Which atypical antiphsychotic has highest risk of dyslipidaemia + obesity?
Olanzapine
SSRI of choice post MI?
Sertraline
presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms
Name?
Erotomania (De Clerambault’s syndrome)
What is histrionic personality disorder characterised by?
inappropriate sexual seductiveness, suggestibility and intense relationships
What is othellos syndrome?
pathological jealousy where a person is convinced their partner is cheating on them without any real proof
Adverse effects of atypical antipsychotics?
weight gain
clozapine is associated with agranulocytosis (see below)
hyperprolactinaemia
Duloxetine MoA?
Serotonin-NA reuptake inhibitor
When do you get:
Symptoms
Seizures
DT
with alcohol withdrawal?
symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours
Mx of DT?
Chlordiazepoxide, lorazepam or diazepam are used in the treatment of delirium tremens/alcohol withdrawal
Which receptor do typical antipsychotics and atypicals act on?
Typical - D2 antagonist - blocking dopaminergic transmission in mesolimbic pathways
Atypical - D2, D3, D4 5HT
When can antidepressants be stopped after remission?
6 months after - reduce risk of relapse
Risk of developing schizophrenia
monozygotic twin has schizophrenia =
parent has schizophrenia =
sibling has schizophrenia =
no relatives with schizophrenia =
monozygotic twin has schizophrenia = 50%
parent has schizophrenia = 10-15%
sibling has schizophrenia = 10%
no relatives with schizophrenia = 1%
Which drugs can cause urinary retention particularly in those with BPH?
TCAs eg amitriptylline
What receptors does Olanzapine act on?
Mainlt - 5HT2A (serotonin) antagonism + D2 (dopamine) antagonism
What are the main features of PTSD?
re-experiencing e.g. flashbacks, nightmares
avoidance e.g. avoiding people or situations
hyperarousal e.g.hypervigilance, sleep problems
Examples of GABA drugs?
benzodiazipines increase the frequency of chloride channels
barbiturates increase the duration of chloride channel opening
How to withdraw from benzos?
switch patients to the equivalent dose of diazepam
reduce dose of diazepam every 2-3 weeks in steps of 2 or 2.5 mg
time needed for withdrawal can vary from 4 weeks to a year or more
Bulimia pharmacological mx?
High dose fluoxetine but limited evidence base
Adverse effects of non-selective monoamine oxidase inhibitors
hypertensive reactions with tyramine containing foods e.g. cheese, pickled herring, Bovril, Oxo, Marmite, broad beans
anticholinergic effects
Can you get alopaecia with long term lithium?
No
Dosulepin MoA? anything to be aware of?
TCA
Dangerous in overdose
Duloxetine MoA?
serotonin and noradrenaline reuptake inhibitor
Which SSRI has highest risk of discontinuation sx?
Paroxetine
What type of memory loss is seen in dementia v pseudodementia?
Dementia = shorter term memory + recent events
Which TCA is safest in overdose
Lofepramine
ECT side effects?
Short-term side-effects
>headache
>nausea
>short term memory impairment
memory loss of events prior to ECT
>cardiac arrhythmia
Long-term side-effects
>some patients report impaired memory
Features of post concussion syndrome?
headache
fatigue
anxiety/depression
dizziness
Anorexia bloods?
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
What is associated with increase in mortalitiy in dementia patients?
antipsychotics
Which APOE allele is highest risk of alzheimers?
y4 allele
Lewy body dementia scan?
SPECT
