Depression Flashcards
(40 cards)
ICD-10 mood disorders
- mania
- bipolar disorder
- depressive disorder
- dysthymia
classification of depression
mild
moderate
severe with or without psychotic symptoms
criteria for depression
at least 2 weeks
no hypomanic or mania symptoms at any time during the patients life
Core features
additional features
Core features of depression
depressed mood
loss of enjoyment in everyday activities
decreased energy
additional features of depression
loss of confidence guilt suicidal behaviour diminished concentration psychomotor retardation sleep disturbance weight change
moderate depression score
2 core + 4 additional = 6 total
severe depression score
3 core + 5 others = 8 total
sub-types of depression
somatic syndrome
atypical depression
psychotic depression
chronic depression
how long does depression last to be chronic?
beyond 2 years
what is somatic syndrome?
loss of pleasure lack of emotion waking 2 hours earlier depression worse in the morning appetite and weight change loss of libido
atypical depression
weight gain and increase in appetite
hypersomnia
leaden paralysis
interpersonal rejection
psychotic depression
paranoia
Cotard’s syndrome
pharmacological class options for depression treatment
monoamine oxidase inhibitors
monoamine reuptake inhibitors
atypical drugs
examples of monoamine oxidase inhibitors
phenelzine (irreversible)
moclobemide (reversible)
action of monoamine oxidase inhibitors
inhibit MAO-A and B
adverse of monoamine oxidase inhibitors
cheese reaction/ hypertensive crisis potentiates other drugs e.g. barbiturates insomnia postural hypotension peripheral oedema
what causes the hypertensive crisis in MAO inhibitors?
inhibition of MAO-A in the gut and liver prevent breakdown of dietary tyramine (diet restriction needed- cheese)
classes of monoamine reuptake inhibitors
tricyclics
selective serotonin reuptake inhibitors (SSRIs)
serotonin norepinephrine reuptake inhibitors (SNRIs)
examples of tricyclics
imipramine
dosulepin
amitriptyline
lofepramine
action of tricyclics
block reuptake of monoamines (mainly 5-HT and NA)
side effects of tricyclics
anticholinergic
sedation
weight gain
cardiovascular
anticholinergic side effects
blurred vision
dry mouth
constipation
urinary retention
cardiovascular side effects in tricyclics
postural hypotension
tachycardia
arrhythmias
cardiotoxic in overdose
examples of SSRIs
fluoxetine citalopram escitalopram sertraline paroxetine
