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Psychiatry > Treatment of Mood Disorders > Flashcards

Treatment of Mood Disorders Flashcards

1
Q

How long do antidepressants usually take to work?

A

2-6 weeks

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2
Q

What should be considered when a patient needs a quicker response than antidepressants can offer?

A

ECT

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3
Q

What is non-response to an anti-depressant?

A

No/inadequate response after 6 weeks at maximum dose

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4
Q

What drug is useful in bipolar depression?

A

Lamotrigine

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5
Q

What drug is useful in mania/hypomania?

A

Valproate

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6
Q

When can antidepressants be used in bipolar disorder?

A

Short term - severe depressive episode

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7
Q

What can be done if the patient is unwilling to take oral medication for bipolar disorder?

A

Depot IM antipsychotics every 2-4 weeks

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8
Q

Which drug class is the first line antidepressant?

A

SSRIs

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9
Q

Give some examples of SSRIs

A 
Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine
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10
Q

Give some side effects of SSRIs

A 
GI upset
Anxiety
Agitation
Insomnia
Sexual dysfunction
Hyponatraemia (older patients)
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11
Q

Which SSRI is safest in cardiac problems?

A

Sertraline

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12
Q

Which SSRI is safest in epilepsy?

A

Citalopram

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13
Q

Give some examples of TCAs

A

Amitriptyline
Clomipramine
Imipramine

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14
Q

Why are TCAs not first line for depression?

A

Cardiac side effects

Danger in OD

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15
Q

Give some side effects of TCAs

A 
Sedation
Confusion
Dizziness
Antimuscurinic effects 
Sexual dysfunction
Cardiac arrhythmias
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16
Q

What type of drug is mirtazapine?

A

Noradrenergic and specific serotonergic antidepressant

17
Q

When is mirtazapine used?

A

First line in insomnia/poor appetite

18
Q

Give some side effects of mirtazapine

A

Constipation
Dizziness
Falls

19
Q

Give some examples of SNRIs

A

Venlafaxine

Duloxetine

20
Q

When are SNRIs generally used?

A

When SSRIs/mirtazapine have not worked

21
Q

Give some examples of MAO inhibitors

A

Irreversible - phelezine

Reversible - moclobemide

22
Q

When are MAO inhibitors used?

A

Treatment resistant depression

23
Q

What is the big risk of MAO inhibitors?

A

Hypertensive crisis

24
Q

Which foods must be avoided in patients taking MAO inhibitors?

A

Cheese
Alcoholic drinks
Dried meats
Gravy based food

25
Q

What is the most effective treatment for bipolar disorder?

A

Lithium carbonate

26
Q

Give some side effects of lithium

A 
GI upset
Dry mouth
Sedation
Weight gain
Tremor
Arrhythmia
Renal impairment
27
Q

What tests must be done prior to giving lithium?

A

U+Es
TFTs
ECG

28
Q

What is tested every 3 months in lithium monitoring?

A

Lithium level

U+Es

29
Q

What is tested every 6 months in lithium monitoring?

A

TFTs

30
Q

Give some signs of lithium toxicity

A 
GI upset
Blurred vision
Coarse tremor
Confusion
Seizures
Coma

Psychiatry (23 decks)

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