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Flashcards in 8 Mental Health Deck (24):
1

Main hypothesis about SCZ?

DA hypothesis - too much DA

2

Long term goals of SCZ treatment

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

3

Widely used screaning tool for depression

PHQ-9 tool

4

What is the role of an advanced directive

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

5

Challenges in clinical trials for psychiatry

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

6

Choice of antidepressant may be based on 4

Safefy
Effectiveness
Tolerabiltiy
Cost
- look at prevous medcation history

7

Mirtazapine is often combined because

s/e

Well tolerated, good cardiac safety

sedation and weight gain

8

At low doses venlafaxine acts as an

SSRI

9

At low doses venlafaxine acts as an

SSRI

10

problems with MAOI

dietary and co-prescription issues

11

Agomelatine is...

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

12

Social and environemtal stressors will not be removed by antidepressants

...

13

minimum time on antidepressants

6 moths

14

Discontinuation symptoms

flu-like
insomnia
nausea
electric shock sensation
vision disturbance
axiety

15

Action for treatment resistant depression

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

Consider other diagnosis - bipoloar compnenet

16

Conventional wisdom is that all antipychotics are equal except

clozapine

17

Atypical vs typical side effects

Typical - movement disorders
Atypical - metabolic disorders

18

Problem with Clozapine

when to use

blood disorders

when other antipsychotics fail

19

Problem with Clozapine

when to use

blood disorders

when other antipsychotics fail

20

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

metabolic
extrapyramidal
cardiovascular
hormonal
other including unpleasant subjective experiences

21

at start of antipsychotic treatment select what dose

the lowest and titrate up

22

trial antipsychotic at optimum dose for how long?

4-6 weeks

23

5 questions to see if your antipscotic is a good choice

-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

24

5 questions to see if your antipscotic is a good choice

-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