Quiznar 2 Flashcards
What is the cause of depression?
Dysregulation of noradrenaline and serotonin
(Therefore depression tx aims to bring these up)
Which sx are associated with DSM-5?
DSM-5 is a diagnostic tool for depression
Signs of depression:
- excessive sleep
- lack of pleasure
- inc appetite
- feelings of guilt
Which antidepressant class is most commonly associated with QT interval prolongation?
Highest risk is SSRI’s (because of citalopram and escitalopram)
Name the 5 classes of antidepressants
- Monoamine oxidase inhibitors MAOIs
- Noradrenaline and specific serotonergic antidepressants
NASSAs - Selective serotonin reuptake inhibitors
SSRIs - Serotonin-noradrenaline reuptake inhibitors
SNRI - Tricyclic antidepressants
TCAs
What is first line for depression and why?
Sertraline
Because it has the lowest risk of QT prolongation
Which antidepressant is safest to prescribe a patient with suicide risk?
Fluoxetine because it is safest in overdose (mirtazepine okay too)
What is the chemical structure of a TCA?
They have three rings duh
What are the symptoms of panic disorder?
- recurrent panic attacks
- intense fear
- palpitations
- sweating
- feeling of impending doom
What is the difference between panic disorder and generalised anxiety disorder (GAD)?
Panic disorder symptoms come on suddenly whereas generalised anxiety disorder is more of a chronic condition and the symptoms are there all the time
What are the symptoms of generalised anxiety disorder (GAD)?
- fatigue
- irritability
- sleep disturbance
- lack of concentration
What is the difference between bipolar one and bipolar two?
bipolar 1 is manic episodes with/without depression, bipolar 2 is more depression
What are the signs of bipolar 1 disorder?
Recurrent mood episodes characterised by periods of elevated and expansive mood consisting of:
- increased energy, racing thoughts, reduce need for sleep, impulsive behaviour
- followed by periods of depression (low mood, fatigue, struggles to concentrate)
What are symptoms of mania in bipolar?
- grandiosity
- irritability
- pressure of speech
- restlessness
What should be started first line for an acute episode of mania?
Antipsychotic is 1st line - risperidone, alanzopine, haloperidol, quitiapine
Second line - lithium or sodium valproate (long term maintenance not so much for acute)
What is the monitoring for lithium?
Every 3 months - serum lithium (for 12 months then every 6 once stable)
Every 6 months - calcium, eGFR, TFT, U&E’s
How long should long term management of an episode of BPAD continue?
At least 2 years to avoid a relapse occurring
