Flashcards in Chapter 9: Treatment of Mood Disorders Deck (62)
What is electroconvulsive therapy used to treat?
Severe depression not responding to meds
How is modern ECT like a surgical procedure?
-Anesthesia and muscle relaxants
-Oxygen to reduce memory loss
-Heart monitor, EEG monitoring, etc.
During what time period was ECT overused?
Describe the levels and duration of the ECT shocks.
-Levels = 12-65 volts
-Duration < 1/2 sec
How long do ECT convulsions last?
How many treatments is ECT?
At least 6-10
What is the relapse rate of ECT?
What are the common and less common side effects of ECT?
-Common = severe headaches, memory loss for events surrounding ECT
-Less common = irretrievable loss of long-term memories
How does transcranial magnetic stimulation work?
Electromagnetic coil is held against patient's scalp that emits powerful magnetic pulses to alter brain activity
What is TMS used to treat?
Treatment-resistant depression mostly
What is VNS used to treat?
What is vagus nerve stimulation? How does it work?
-Surgical implantation of a pulse generator in left upper chest --> wires go from upper chest into the neck and send mild pulses every 5 mins to left vagus nerve --> to the brain areas involved in regulation of mood, motivation, sleep, appetite, etc.
What are some side effects of VNS?
Voice alteration or hoarseness
What is light therapy used to treat?
Seasonal Affective DIsorder
What equipment does light therapy require?
Light boxes (at least 10K lux)
When did tricyclics start becoming available?
What are tricyclics? What do they treat?
-Mostly norepinephrine reuptake inhibitors
-Treat mood disorders
What are the side effects of Tricyclics?
What does SSRI stand for?
Serotonin Selective Reuptake Inhibitors
When did SSRIs become available in the U.S.?
How do SSRIs work?
By blocking serotonin reuptake so it stays in the system
What are the advantages of SSRIs over tricyclics?
-Generally fewer side effects
-Less dangerous in overdose
-Less interaction w/ alcohol
-Faster action that tricyclics (2-3 weeks vs. 5-6 weeks)
-More effective for OCD
-More effective for sensitivity to rejection
What are the side effects of SSRIs?
-Sexual = delayed orgasm, decreased desire or arousal
-Headaches and GI probs
-Elevated suicide risk b/c very activating
-Increased energy before mood & negative thoughts improve
When did MAO inhibitors become available?
How do MAO inhibitors work?
-Block enzymes at synapses that degrade excess NT at synapses
-Increase norepinephrine, serotonin, dopamine
What are the problems associated w/ MAO inhibitors?
-Block same enzymes in live and intestines --> causes tyramine build up
-Danger of hypertensive crisis (stroke, heart attack)
-Dangerous interactions w/ most other medications
What does SNRI stand for?
Serotonin-Norepinephrin Reuptake Inhibitors
How do SNRIs work?
Block reuptake of both norepinephrine and serotonin
What does NDRI stand for?
Norepinephrine-Dopamine Reuptake Inhibitors