Depression Pharmaceutical Care Flashcards
What is depression characterised by?
Persistent low mood
Loss of pleasure
Range of associated emotional, cognitive, physical + behavioural symptoms
COMBO OF BOTH
What are the 2 core things you need to ask?
How often have you been feeling down?
Do you have little interest/pleasure in doing things?
What is the PHQ-9?
Patient health questionnaire for depression
What is the DSM-5 classification?
Presence of at least 5 out of possible 9 defining symptoms
Present for at least 2 weeks
Sufficient severity to cause clinically significant distress in social, occupational or other areas of functioning
What are the complications?
Exacerbation of pain, disability + distress
Reduced QoL for person + family
Increased morbidity + mortality
What are the risks?
Risks of suicide
Any factors which may affect development, course + severity depression
Safeguarding concerns
Effect on other medications
How do you asses the risk of suicide?
Do you ever think about suicide?
Have you made any plans to end your life?
Do you have the means to end your life?
What has kept you from acting on these thoughts?
How do you manage the risk of suicide?
Make the aware of the support available
Find out what makes them happy
Exercise + diet
Family/social support?
If they have a plan they need referring to a crisis team
How often should you see someone on anti-depressants?
Recommend seeing them every 2 weeks
BUT if under 30 need to be seen more often
What is the 1st line treatment?
CBT (talking therapy)
BUT long waiting list
When are antidepressant prescribed?
NOT 1st line BUT long waiting list for CBT
How long does it take for antidepressants take to work?
6-8 weeks
= increased risk of suicide
How do you prescribe antidepressants?
Based on clinical need
What CANNOT be taken with standard depression?
St John’s Wort
What would happen if you suddenly stopped taking antidepressants?
Discontinuation symptoms
Need to take them for at LEAST 6 months
