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
