Psychiatry Flashcards
Side effects of SSRI
Shit, Sex, Sleep, Serotonin syndrome, Slow onset
Symptoms of Serotonin syndrome and what can cause it
- TCA, MOA, St john wort, amphetamine, ecstasy
- Hyperrefelxia (+ rigidity)
- increased sweating and hyperthermia
- dilated pupils
- confusion
Symptoms of SSRI discontinuation
GI disturbances, Flu, mood changes, insomnia, electric shock, restless, dizzy
what class of mirtazipine
noradrenergic and selective serotonin reuptake inhibitor (NaSSa)
for which anti-depressant do you need to monitor blood pressure
venlaflaxine (HTN)
which anti-depressant is best for co-morbidities/ polypharmacy
sertraline
What are shneider’s first rank symptoms
auditory hallucinations, thought; broadcast, insertion, withdrawal and delusional perception
how long to schizophrenic symptoms have to last for
> 6 months
If schizo symptoms last less than 6 months what is the disorder called?
Schizophreniform (high risk of developing schizophrenia, common in younger patients)
What are good and bad markers of prognosis in schizophrenia
Good - short prodrome (less than 3 months), female, only positive symptoms, no FHx, social support
Bad - the opposite FHx is the main
Alcohol withdrawal seizure NAME and peak incidence
grand mal seizures, 4 - 48 hours after last drink
Alcohol withdrawal acute treatment
1) benzodiazepines –> carbamazepine
2) If delirium tremens give lorazepam + PABRINEX
and for seizures
Alcohol withdraw if requesting help
1) if <15 units, motivational interviewing, pyschological therapy (couples if relevant) and review regularly + drugs, can associate with CGL etc.
2) if >15 units OR >20 on AUDIT –> assissted withdrawal in the community (over 3 weeks) with CGL
3) if >30 units or >30 on AUDIT OR vulnerable –> in-patient withdrawal; 1) chlordiazepoxide / diazepam
* if liver failure can give lorazepam
- -> reduce dose over 7 days
- -> F/U for 6 months with CBT and acamprosate/ naltrexone
Opioid withdrawal symptoms
1) GI disturbances
2) Cravings
3) increased sweating (diaphoresis)
4) goosebumps (piloerection)
5) yawning, nausea, vomiting, mood changes
Opioid DETOX management
Inpatient (4 weeks) or outpatient (12 weeks)
Withdrawal (DETOX) is quickened with naltrexone/ naloxone
1) rapid detox - in patient with sedation
2) accelerated detox - no sedation
- maintenance on methadone (liquid)/ buprenorphine (sub lingual)
+ Key worker, CBT (family help), social support, vaccines etc.
