Chapter 9: Treatment of Mood Disorders Flashcards Preview

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Flashcards in Chapter 9: Treatment of Mood Disorders Deck (62)
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1

What is electroconvulsive therapy used to treat?

Severe depression not responding to meds

2

How is modern ECT like a surgical procedure?

-Anesthesia and muscle relaxants
-Oxygen to reduce memory loss
-Heart monitor, EEG monitoring, etc.

3

During what time period was ECT overused?

1940s-mid 1960s

4

Describe the levels and duration of the ECT shocks.

-Levels = 12-65 volts
-Duration < 1/2 sec

5

How long do ECT convulsions last?

Several mins

6

How many treatments is ECT?

At least 6-10

7

What is the relapse rate of ECT?

60%

8

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

9

How does transcranial magnetic stimulation work?

Electromagnetic coil is held against patient's scalp that emits powerful magnetic pulses to alter brain activity

10

What is TMS used to treat?

Treatment-resistant depression mostly

11

What is VNS used to treat?

Treatment-resistant depression

12

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.

13

What are some side effects of VNS?

Voice alteration or hoarseness

14

What is light therapy used to treat?

Seasonal Affective DIsorder

15

What equipment does light therapy require?

Light boxes (at least 10K lux)

16

When did tricyclics start becoming available?

Mid 1960s

17

What are tricyclics? What do they treat?

-Mostly norepinephrine reuptake inhibitors
-Treat mood disorders

18

What are the side effects of Tricyclics?

-Weight gain
-Sedation
-Constipation
-Dry mouth

19

What does SSRI stand for?

Serotonin Selective Reuptake Inhibitors

20

When did SSRIs become available in the U.S.?

1989

21

How do SSRIs work?

By blocking serotonin reuptake so it stays in the system

22

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

23

What are the side effects of SSRIs?

-Sexual = delayed orgasm, decreased desire or arousal
-Headaches and GI probs
-Zombie-like feeling
-Elevated suicide risk b/c very activating
-Increased energy before mood & negative thoughts improve

24

When did MAO inhibitors become available?

1960s

25

How do MAO inhibitors work?

-Block enzymes at synapses that degrade excess NT at synapses
-Increase norepinephrine, serotonin, dopamine

26

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)
-Food restrictions
-Dangerous interactions w/ most other medications

27

What does SNRI stand for?

Serotonin-Norepinephrin Reuptake Inhibitors

28

How do SNRIs work?

Block reuptake of both norepinephrine and serotonin

29

What does NDRI stand for?

Norepinephrine-Dopamine Reuptake Inhibitors

30

How do NDRIs work?

Blocks reuptake of mostly dopamine and also norepinephrine