PSYCHIATRY 2 Flashcards
On the mood disorder spectrum what does Bipolar affective disorder incl?
- Mania w/ Psychosis
- Mania
- Hypomania
- Elation
- Normal Mood
- Dysthymia
- Mild depression
- Moderate Depression
- Sev Depression
- Sev Depression w/ Psychosis
On the Mood disorder spectrum, what does Cyclothymia include and what is it?
- Normal mood swing
- Elation - Normal mood - dysthymia
What are the ratios for Mood disorders?
- Female: Male 2-3:1
- Unipolar - 6% point prevalence
- Bipolar 1.2% prevalence
What are common Depressive Mood disorders?
- Major depressive disorder
- Persistent Depressive Disorder
- Bipolar Depression
- Postpartum Depression
- Premenstrual Dysphoric Disorder
- Seasonal affective disorder
- Atypical Depression
List 5 (of many) common symptoms of depression
- Low mood
- Reduced interest & motivation
- Lethargy & tiredness
- Sleep disturbance
- Appetite disturbance
- Poor Conc
- Loss of confidence & Self-esteem
- Recurrent thoughts of death & suicide
- Unreasonable Self-reproach & guilt
- Any form of anxiety - can be associated w/ depression
What are the 2 types of Bipolar on the spectrum
- Bipolar 1 - Normal - Mania are interchangeable
- Bipolar 2 - Leads to mania w/ psychosis
What are some associated symptoms with Mania and Hypomania?
- Increased Prod & feeling of wellbeing
- Reduced need for sleep
- Gradual reduction in social functioning
and occupational func - Increase in reckless behaviour (dont realise that there are downsides associated with them)
- Followed by period of depression
What are the 2 types of elevated mood disorders?
- Euphoric
- Dysphoric
What are the common factors of Elevated mood disorders?
- Rapid speech
- Restlessness
- Reckless Behaviour
- Excessive energy
- Decreased sleep
What are symptoms of Euphoric Elevated mood disorders?
Upbeat
More talkative
Inflated self-esteem
felt everything was possible
What are symptoms of Dysphoric elevated mood disorders?
Irritable
Agitated
Aggressive energy
Restlessness
Rage
What are the different kinds of treatment for Mood disorders?
- Psychological (cognotive therapy or interpersonal psychotherapies)
- Drug Tx (antidpressants/mood staibalising tx) - Req for 2 yrs
- Physical (Excersize/phototherapy/ECT)
What Tx is best for S.A.D?
Phototherapy
What is ECT therapy? And what is it good for?
electric convulsive therapy
good for helping with a low mood
Good for post-natal depression
List the 4 main types of Acute phase Antidepressive drugs
- Selective Serotiin Reuptake Inhibitor - SSRI - diff types available
- Venalfaxine/Mitrazepine (2nd line)
- tricyclic antidepressants (TCA)
Monoamine Oxidase Inhibitor (MAOI) - not used due to side effects
List the 4 Mood stabilising Drugs
Lithium
Carbamazepine
Valproate
Lamotrigine
What are uses of depressants?
- Treating depression
- Treating anxiety disorders - incl OCD & panic attacks
- Pain relief
Help Psychological Tx’s
List TCAs and their side effects?
Original - amitriptyline, nortiptyline, dosulepin
New - Imipramine, doxepin
Side effects - Drymouth, Sedation, Weight gain
What should TCAs be used in caution with?
Glaucoma & Prostatism
What are the MAOI interactions
- Indirect sympathomimetic amines
-Enhanced vasoconstrictor effect - Cold and cough remedies
- W/ food - tyramine containing, alcohol, marmite,cheese, herring and beans - if Px eats this cannot give MAOI
SSRI side effects?
- GI upset
- Acute anxiety disorders
- Sedation & dry mouth
What are other drugs used as antidepressants that psychiatrist involvement usually occurs?
- Venlafaxine (mixed SRI/RI)
-Mirtazapine
-Nefazodone (SSRI)
-Reboxetine
What drugs are used to treat bipolar disorder?
- Lithium (but avoid NSAIDs)
- Carbamazepine/Lamotrigine/Valproate - mood stabiliser
What are the antispychotic medicines used in treating episodes of mania?
- Aripiprazole
- Olanzapine
- Quetiapine
- Risperidone
