Psychiatry

Question 1

Depression (I)

Question 2

Depression (II)

Question 3

DSH / Suicide

Question 4

Postnatal Depression

Question 5

SSRIs

Question 6

Bipolar Disorder

Question 7

Lithium

Question 8

Anxiety

Question 9

GAD

Question 10

Panic Disorder

Question 11

Phobias

Question 12

OCD

Question 13

Psychosis

Question 14

Schizophrenia

Question 15

Eating disorders

Question 17

PTSD

Question 18

Learning and Communication Problems

Question 19

Medically Unexplained Symptoms

Question 20

Delirium / Acute confusion

Question 22

Dementia

Question 24

Tricyclic Antidepressants (I)

Answer 24

● Examples: Amitriptyline, Clomipramine, Imipramine
● Indications: Depression, Anxiety diosrders, Neuropathic pain
● Work by blocking the re-uptake of both serotonin & noradrenaline
● Similar efficacy to SSRIs but are more likely to be discontinued because of side-effects

● Contraindications include:
* Acute porphyrias
* Arrhythmias, Heart block
* Severe hepatic impairment
* Severe renal impairment (lofepramine)
* During manic phase of bipolar disorder
* Post MI recovery
* Taking a monoamine oxidase inhibitor (MAOI)

Question 25

Tricyclic Antidepressants (II)

Answer 25

● Cautions include:
* Elderly,
* History of bipolar disorder, Psychosis, Significant suicide risk,
* Uncompensated heart failure, Bradycardia, Chronic constipation, Convulsive disorders,
* Diabetes, Hyperthyroidism,
* Increased intraocular pressure, Phaeochromocytoma,
* Prostatic hypertrophy,
* Urinary retention

● Side effects include:
* Cardiac (eg palpitations, tachycardia, AV block),
* Eye (eg accommodation disorder,
* mydriasis, blurred vision),
* GI (eg dry mouth, nausea, constipation), Neurological (eg tremors, dizziness, headache, drowsiness, speech disorders),
* Psychiatric (eg aggression, confusional states, agitation),
* Urinary retention,
* Erectile dysfunction,
* Bone fractures,
* Fatigue,
* Orthostatic hypotension

● If possible should be withdrawn slowly wen stopping