Depression Flashcards
0
Q
What can contribute to depression?
A
Substance abuse - alcohol, THC, nicotine, opiates, stimulants Drugs/hormones Stresses/losses Medical - low thyroid - anemia - chronic pain - infection - electrolytes - liver - CV - Alzheimer's - epilepsy - parkinson's
1
Q
How is depression diagnosed?
A
- not caused by meds, illness, drug abuse, bereavement
- last >2 months or mark functional impairment, preoccupation with worthlessness, SI, psychosis, psychomotor retardation
- must include depressed mood or anhedonia and 5 or more of the following:
- depressed most of the day
- anhedonia
- weight loss
- sleep disturbance
- psychomotor changes
- fatigue
- feeling of worthlessness or guilt
- can’t concentrate or make decisions
- thoughts of death or SI
2
Q
How is depression diagnosed/screened?
A
- with validated questionnaires
- medical/pharmacologic work up that MUST include thyroid function
3
Q
Why must the thyroid be tested is pts with depression?
A
because the thyroid determines how the antidepressant will work
4
Q
What are the potential upsides of using a benzodiazepine for depression?
Hazards?
A
- it will help the pt sleep and relax
- because benzos work so fast, pt may think their depression is cured and no longer needs therapy
- may become addicted
5
Q
What do antidepressants target?
Why don’t they work quickly?
A
- the NTs that we think are involved with depression
- because simply adding more NTs doesn’t immediately fix the problem
6
Q
What is the most common type of drug action for pts with depression?
A
- to block the reuptake of certain NTs
- also to decrease degradation of NTs
- both actions cause more NTs to be available to bind
7
Q
What are the markers of poor outcomes in the Tx of depression?
A
- longer time undertreated
- more severe presentation
- number of episodes
- frequency of relapse
8
Q
What are the marker of good outcomes in the Tx of depression?
A
- access to support
- adherence to treatment
- a history of “quick” response
- lower life stressors
