Treatments

Question 1

Schizoaffective disorder?

Answer 1

1) Hospitalize + psychotherapy

2) Antipsychotics + mood stabilizers; antidepressants or ECT for mood sxs

Question 2

Delusional disorder?

Answer 2

Psychotherapy, antipsychotics should be tried but usually fail

Question 3

Shared psychotic disorder?

Answer 3

1) Separation

2) Psychotherapy and antipsychotics if sxs not improved in 1-2 wks

Question 4

Rapid cycling bipolar and mixed episodes?

Answer 4

Anticonvulsants

Question 5

Dysthymia?

Answer 5

CT and insight oriented psychotherapy + antidepressants

Question 6

Cyclothymia?

Answer 6

Mood stabilizers (same as bipolar)

Question 7

Adjustment disorder?

Answer 7

Supportive psychotherapy most effective

Question 8

Panic disorder?

Answer 8

1) Immediate = BZDs
2) Long term = SSRIs (paroxetine and sertraline)
3) Clomipramine or imipramine maybe

Question 9

Specific phobia?

Answer 9

CBT 1st line (not drugs!)

Question 10

Social phobia?

Answer 10

1) Paroxetine
2) B-blockers for performance anxiety
3) Assertiveness training

Question 11

OCD?

Answer 11

1) SSRIs or clomipramine
2) Behavioral therapy (as effective as drugs)
3) Exposure and response prevention (ERP)
4) ECT or cingulotomy

Question 12

PTSD?

Answer 12

1) SSRIs (1st line), TCAs (imipramine, doxepin), MAOIs
2) Anticonvulsants (for flashbacks and nightmares)
3) Psychotherapy
4) Eye mvt desensitization and reprocessing (EMDR)

Question 13

ASD?

Answer 13

Same as PTSD

Question 14

GAD?

Answer 14

1) SSRIs/SNRI (venlafaxine)
2) Buspirone
3) BZDs (clonazepam, diazepam)
4) CBT

Question 15

DTs?

Answer 15

1) Chlordizepoxide, diazepam, lorazepam
2) Antipsychotics for agitation
3) Thiamine, folic acid, multivitamin (banana bag)

Question 16

Barb OD?

Answer 16

1) Alkalinize urine

2) Na bicarb

Question 17

Delirium?

Answer 17

1) Tx cause
2) Haloperidol 1st line
2) Avoid BZDs!!!

Question 18

Mild to moderate dementia?

Answer 18

ACEIs

Question 19

Moderate to severe dementia?

Answer 19

Memantine

Question 20

Lewy body dementia?

Answer 20

ACEIs for visual hallucinations

Question 21

Pick’s?

Answer 21

Anticholinergics + antidepressants

Question 22

HIV dementia?

Answer 22

HAART

Question 23

Pseudodementia?

Answer 23

1) Supportive
2) Low dose SSRIs
3) If using TCAs in elderly, use nortriptyline (fewest anticholinergic AEs)
4) Mirtazapine (for appetite and sedation)
5) Methylphenidate (for psychomotor retardation)
6) ECT

Question 24

ADHD?

Answer 24

1) Stimulants
2) Atomoxetine (nonstimulant)
3) Alpha-2 agonists (clonidine, guanfacine)
4) If underlying mood/anxiety disorder, tx that first

Question 25

Tourette's?

Answer 25

1) Risperidone | 2) Haloperidol, pimozide (for severe cases)

Question 26

Tourette's + ADHD?

Answer 26

Alpha-2 agonists

Question 27

Enuresis?

Answer 27

1) Behavioral therapy 1st line 2) Desmopressin 3) Imipramine

Question 28

Dissociative disorders?

Answer 28

Psychotherapy

Question 29

Somatization disorder?

Answer 29

Regularly scheduled visits with a SINGLE primary care doc

Question 30

Conversion disorder?

Answer 30

Insight oriented psychoterhapy hypnosis, relaxation therapy

Question 31

Hypochondriasis?

Answer 31

CBT (most useful), regularly scheduled visits to one primary care doc

Question 32

Body dysmorphic disorder?

Answer 32

SSRIs (work 50% of time)

Question 33

Pain disorder?

Answer 33

SSRIs, analgesics not helpful

Question 34

Factitious disorder?

Answer 34

Avoid early confrontation

Question 35

Intermittent explosive disorder?

Answer 35

SSRIs, anticonvulsants, lithium, propranolol, psychotherapy is not helpful

Question 36

Kleptomania?

Answer 36

Psychotherapy, behavioral therapy, systematic desensitization, aversive conditioning, SSRIs

Question 37

Pathologic gambling?

Answer 37

Gamblers Anonymous (12 steps) most effective

Question 38

Trichotillomania?

Answer 38

SSRIs, antipsychotics, lithium

Question 39

Pyromania?

Answer 39

BT, supervision, SSRIs

Question 40

Anorexia?

Answer 40

1) Olanzapine 2) CBT 3) BZDs before meals to reduce preprandial anxiety

Question 41

Bulimia?

Answer 41

1) Fluoxetine 1st line | 2) CBT

Question 42

Binge eating disorder?

Answer 42

1) Stimulants (suppresses appetite) 2) Orlistat 3) Sibutramine

Question 43

Chronic insomnia?

Answer 43

CBT 1st line

Question 44

Insomnia (drugs)?

Answer 44

1) BZDs (use short term, 4-8 wks) 2) Non-BZDs (lower incidence of daytime sleepiness and orthostatic hypotension) 3) Trazodone, amitriptyline, doxepin

Question 45

Most common reason to Rx long term BZD?

Answer 45

Insomnia

Question 46

Cataplexy?

Answer 46

Na oxybate (DOC), SSRIs, TCAs

Question 47

Circadian rhythm disorders?

Answer 47

Melatonin

Question 48

Sleepwalking?

Answer 48

Clonazepam or TCA

Question 49

Sleep terror?

Answer 49

Clonazepam, diazepam

Question 50

Nightmare disorder?

Answer 50

Imagery rehearsal therapy (esp in PTSD)

Question 51

REM sleep behavior disorder?

Answer 51

Clonazepam