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Flashcards in Depression Deck (17):
1

criteria

>2 week duration
ICD 10: (4 of)
G - guilt
C - confidence
A - appetite
S - sleep
C - concentration
A - agitation
S - suicidal

<4 = not depressed
6 (2 core) = moderate
8 (3 core) = severe

2

first line treatment

SSRI - fluoxetine, citalopram

3

treatment in adolescents

fluoxetine

4

medication linked with long QT syndrome

citalopram

5

contraindication to SSRI

warfarin/heparin

6

If taking NSAID and you prescribe an SSRI what do you need to do?

Give PPI

7

second line

another SSRI

8

third line

SNRI (more SE than SSRI, venlafaxine), NaSSA (noradrenaline and selectove serotonin transmission is increased, mirtazapine - is sedating and causes hunger)

9

fourth line

tricyclic AD (safe in pregnancy) - serotonin and noradrenaline reuptake inhibition. Imipramine, amytriptyline

10

SE of imipramine

anticholinergic - dry mouth, blurred vision

11

ehat score can be used to assess severity

PHQ-9 score

12

when switching to another SSRI what do you do

withdraw, gap of 4-7 days then start new one

13

how do MAO work and what is a risk

inhibit MAO-A and B so decresed breakdown of monoamine neurotransmitters so more in synapse. MAO-A also metabolises peripheral amines so food high in tyramine eg cheese shoudl be avoided - can induce hypertensive crisis

14

when to use ECT

catatonia, prolonged severe manic episode, severe depression that is life threatening

15

SE of ECT

headache, nausea, short term mem loss, cardiac arrythmias, impaired memory (long term)

16

how long are ADs given for

6-12 months after full recovery of 1st episode, 12-24 for recurrence, lifelong if third episode

17

how can SSRI discontinuation syndrome present

diarrhoea, vom, abdo pain, restlessness, sweating, diff sleeping, increased mood change, parasthesia