8 Mental Health

Question 1

Main hypothesis about SCZ?

Answer 1

DA hypothesis - too much DA

Question 2

Long term goals of SCZ treatment

Answer 2

Symptom control
Prevent relapse and re-admission
Ensure tolerability / safety
Improve quality of life
Improve social functioning
Reduce cost

Question 3

Widely used screaning tool for depression

Answer 3

PHQ-9 tool

Question 4

What is the role of an advanced directive

Answer 4

e.g. if I become suicidal I would like to have ECT again

Question 5

Challenges in clinical trials for psychiatry

Answer 5

Recruitment challenge
what is an appropriate outcome measure
length of time needed to follow up

Question 6

Choice of antidepressant may be based on 4

Answer 6

Safefy
Effectiveness
Tolerabiltiy
Cost
- look at prevous medcation history

Question 7

Mirtazapine is often combined because

s/e

Answer 7

Well tolerated, good cardiac safety

sedation and weight gain

Question 8

At low doses venlafaxine acts as an

Answer 8

SSRI

Question 9

At low doses venlafaxine acts as an

Answer 9

SSRI

Question 10

problems with MAOI

Answer 10

dietary and co-prescription issues

Question 11

Agomelatine is…

Answer 11

acts on melatonin receptors - new and place in therapy is not yet established

Question 12

Social and environemtal stressors will not be removed by antidepressants

Answer 12

…

Question 13

minimum time on antidepressants

Answer 13

6 moths

Question 14

Discontinuation symptoms

Answer 14

flu-like
insomnia
nausea
electric shock sensation
vision disturbance
axiety

Question 15

Action for treatment resistant depression

Answer 15

Switch to another drug
Augment with:
Li, anti psychotic, thyroid hormones

Consider other diagnosis - bipoloar compnenet

Question 16

Conventional wisdom is that all antipychotics are equal except

Answer 16

clozapine

Question 17

Atypical vs typical side effects

Answer 17

Typical - movement disorders

Atypical - metabolic disorders

Question 18

Problem with Clozapine

when to use

Answer 18

blood disorders

when other antipsychotics fail

Question 19

Problem with Clozapine

when to use

Answer 19

blood disorders

when other antipsychotics fail

Question 20

5 types of s/e patients should be informed about with antipsycotics

Answer 20

metabolic
extrapyramidal
cardiovascular
hormonal
other including unpleasant subjective experiences

Question 21

at start of antipsychotic treatment select what dose

Answer 21

the lowest and titrate up

Question 22

trial antipsychotic at optimum dose for how long?

Answer 22

4-6 weeks

Question 23

5 questions to see if your antipscotic is a good choice

Answer 23

• is the drug choice logical
• has there been discussion in choice
• how will efficacy be monitored
• how will s/e be monitoered
• do benifits outweigh risks

Question 24

5 questions to see if your antipscotic is a good choice

Answer 24

• is the drug choice logical
• has there been discussion in choice
• how will efficacy be monitored
• how will s/e be monitored
• do benefits outweigh risks