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Flashcards in Depression Deck (30):
1

What are the Kubler Ross stages of grief?

DABDA
Denial
Anger
Bargaining
Depression
Acceptance
**can happen with loss or imminent loss or any major life event

2

What are the risk factors for suicide?

DIT:
Psych disorder
Feelings of hopelessness or worthlessness
Impulsivity
increased age (younger-attempt more, older-successful more)
Male sex (women attempt more, men succeed more)
Access to weapons (firearms)
Hx of suicide attempt

SADPERSONS:
Sex (male)
Age (young & old)
Depression
Previous Attempt
EtoH or drug use
Rational thinking gone
Sickness
Organized Plan
No spouse
Social support lacking

3

What is required for diagnosis of Major Depressive Disorder?

5/9 SIGECAPS for >2 wks, must include anhedonia or depressed mood

4

What is persistent depressive disorder (dysthymia)?

depression (sometimes milder)>2 years

5

What is atypical depression?

mood reactivity (happier when good things happen)
interpersonal rejection sensitivity
leaden paralysis
hypersomnia
hyperphagia
1. CBT & SSRIs
2. MAO inhibitors

6

What are the features of sleep in MDD?

Increased REM
decreased REM latency
Increased REM early in sleep cycle
less slow wave sleep
**repeated nighttime awakenings and early morning awakening

7

What are the SSRIs?

Flashbacks paralyze senior citizens
fluoxetine
paroxetine
sertraline
citalopram

8

What are the SE of SSRIs?

sexual dysfunction
risk for serotonin syndrome
SIADH, GI distress

9

What are the SNRIs? What is their MOA?

Venlafaxine
duloxetine
desvenlafaxine
minacipran
inhibit 5-HT and NE reuptake

10

What else is venlafaxine used for?

generalized anxiety disorder
panic disorder
PTSD

11

What else is duloxetine used for?

diabetic peripheral neuropathy, chronic pain

12

What is minacipran used for?

not depression
fibromyalgia

13

What are the TCAs? What is their MOA?

**inhibit 5-HT and NE reuptake
amitriptyline
nortriptyline
imipramine
desipramine
clomipramine
doxepin
amoxapine

14

What is a special function of imipramine ?

helps w/ bed wetting

15

What else is clomipramine used for?

OCD, like trichotillomania

16

What are the SE of TCAs?

Tri-Cs
anti-Cholinergic: tachycardia, urinary retention, dry mouth, confusion, hallucination
Cardiotoxicity: prolong QT interval, arrhythmias
CNS toxicity: seizures, coma

17

What is the treatment for OD on TCAs?

NaHCO3

18

What are some MAOIS?

MAO Takes Pride In Shanghai
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
Rasagiline

19

What else are selegiline and rasagiline used for? MOA?

specifically inhibit MAO-B which break down dopamine
used to treat Parkinson's

20

What is the SE of MAOIs?

HTN crisis w/ ingestion of tyramine (in old cheese etc)
Serotonin Syndrome

21

What does tyramine do exactly at nerve terminals?

stimulates release of NE along with amphetamines and ephedrine

22

What are some drugs that when taken together could cause serotonin syndrome?

SSRIs
SNRIs
TCAs
MAOIs
Triptans (migraines)
St. John's Wart
Kava-kava
amphetamines

23

What is the MOA of bupropion?

we don't know, but increases NE and dopamine

24

What are the side effects of bupropion?

stimulation-insomnia
seizures, esp if anorexic or bulimic
NO SEXUAL SIDE EFFECTS

25

What is another indication for bupropion?

smoking cessation

26

What is the MOA of mirtazapine?

alpha 2 antagonist
weirdly 5-HT2 and 5-HT3 antagonist

27

What are the side effects of mirtazapine?

sedation and dry mouth
increase in appetite and weight gain
great for skinny insomniacs who are elderly

28

What is the MOA for trazadone and nefazadone?

inhibits 5-HT2 and alpha 1

29

What is the main indication for trazadone and main SE?

used for insomnia (not really for depression)
main side effect is priapism.

30

What are the symptoms of serotonin syndrome?

muscle rigidity
cardiovascular collapse (autonomic instability)
hyperpyrexia