psychiatry Flashcards
SIGECAPS stands for?
Sleep disorder (increased or decreased) Interest deficit (anhedonia) Guilt (worthlessness, hopelessness, regret) Energy deficit Concentration deficit Appetite disorder (increased or decreased) Psychomotor retardation or agitation Suicidality
sigecaps is used to screen for
major depression and persistent depressive disorder
Dysthymic disorder -how long is depression present for?
daily for 2 years
When do symptoms of Adjustment disorder occur and resolve?
within 3 months of the stressor and lasts <6 months after the stressor disappears
acute phase of suicide treatment last how many weeks
6-12 weeks
full remission of suicide treatment is considered how long?
2 month period free of depression symptoms
Serotonin syndrome symptoms
ABD pain, diarrhea, flushing, sweating, hyperthermia, lethargy, mental status change, tremor, rhabdomyolysis, renal failure, CV shock and potentially death
sexual dysfunction usually occurs with which drug class?
SSRIS
TCAS should be used cautiously in which type of patients?
heart problems
Atypical Antipsychotics put people at risk for which problems?
diabetes, obesity, metabolic syndrome, hyperlipidemia and hypothyroidism
Atypical Antipsychotics include?
quetiapine( Seroquel), aripiprazole(abilify) and combination of olanzapine (Zyprexa) in combo with prozac
what med class can pregnant people take?
SSRIs
what med class should you start an elderly patient on with severe depression?
TCA, nortriptyline
drugs for postpartum depression
zoloft (SSRI), Paxil (SSRI), or nortriptyline (TCA)
what screen should we use for pregnant patients?
Edinburgh Postnatal Depression Scale (EPDS)
1st episode (major depression, single episode) treatment duration
Continue medication treatment for 4-9 months once remission is reached.
Total = approximately 6-12 months
2nd episode (major depression, recurrent) treatment duration
Continue medication treatment for 2-3 years once remission is reached. Withdraw gradually.
if patient doesnt have a response to an antidepressant after 3 weeks what should you do
change to different med
hallmark differences between Generalized anxiety disorder and Panic disorder?
GAD is excessive, out-of-control worry
PD is recurrent and unexpected panic attacks.
Bipolar I (How many manic/hypomanic episodes and how long does it last)
manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.
Bipolar II (How many manic/hypomanic episodes and how long does it last)
pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes
Cyclothymic Disorder (How many manic/hypomanic episodes and how long does it last)
numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years
examples of SSRIs
Celexa, Lexapro, Paxil, Prozac, Zoloft
examples of SNRIs
Effexor, Cymbaltal, Pristiq
Pristiq is good for which problem and what drug class is it?
bipolar, SNRI
Bipolar mood stabiling meds
depakote, lamictal, lithiu, tegretol
antipsychotics used for bipolar
abilify, latuda, zylprexa, seroquel, geodon
aide effects of SSRI
headache, nervousness, insomnia, sexual dysfunction
how long do anti-depressants take to work
3-4 weeks
what meds do SSRIs interact with?
triptans
risk factors for GAD and panic disorder
female, unmarried, poor physical health, low education level
common age for GAD and panic disorder
30
diagnostic criteria for GAD are associated with 3 or more of the 6 symptoms (but not more for the last 6 months
1.)restlessness or feeling up or on edge
2.) Being early fatigued
3,) Difficulty concentrating
4.) Irritability
5.) Muscle tension
6.) Sleep disturbances
GAD-7 screening tool
21
What is the PHQ-9 goal?
<5
PHQ-9 is out of
27
PHQ-2 is out of
6
How often should Psychotherapy be preformed
weekly for at least 8 weeks
what is psychotherapy used for
GAD and PD
Do rebound symptoms occur less with psychotherapy than with use of meds?
yes
What types of psychotherapy are beneficial for bipolar
cognitive behavior therapy, family focused therapy, interpersonal and social therapy, psychoeducation
