Week Seven

Question 1

Treatment resistant depression patients

Vagal nerve stimulator

Answer 1

• stimulates the Vagal nerve.
• Used to control seizures in the past.
• Cost over $20,000 and insurances are very slow to pay for it because they describe it as somewhat experimental.
• Involves electrical stimulation of the left Vagal Nerve by an implanted device.
• Used for treatment resistant depression.

Question 2

Treatment resistant depression patients

Transcranial Magnetic Stimulation (TMS)

Answer 2

• For treatment resistant depression
• Repetitive stimulation of the prefrontal cortex which effects the Limbic circuits and acts on neurotransmitter systems
• Newer versions of this approach are being studied. Current results are modest.

Question 3

If we see the depressive symptoms in spades, what should we ask before diagnosis?

Question 4

What should be considered if patient is in manic phase?

Answer 4

• Hospitalization

Question 5

Disruptive mood dysregulation disorder

Answer 5

• Children older than 5 with temper/rage outbursts
• The working name “Temper dysregulation disorder with dysphoria” was abandoned
• It is intended to address the over diagnosis of bipolar disorder in children