Depression and Treatment

Question 1

what aspect of depression do these sx address: depresed mood, anhedonia, decreased interest, irritability, guilt/worthlessness, suicidal ideation

Answer 1

psychological

Question 2

what aspect of depression do these sx address: appetite, sleep, energy, concentration

Answer 2

neurovegative

Question 3

What does SIGECAPS stand for?

Answer 3

sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicidal

Question 4

Frequency of depressive symptoms that qualifies it as a disorder

Answer 4

symptoms occur in the same two weeks, most of the day and nearly everyday

Question 5

Risk factors include: family h/o, childhood onset of depression, no response or agitation to antidepressants

Answer 5

bipolar disorder

Question 6

sx include: euphoria, irritability, grandiosity, increased energy, decreased sleep, risk taking, more talkative

Answer 6

bipolar disorder

Question 7

Type of bipolar characterized by mania that lasts one week and marked impairment

Answer 7

bipolar disorder I

Question 8

Type of bipolar characterized by hypomania that lasts 4 days and there is a change that is observable by others

Answer 8

bipolar disorder II

Question 9

Psychotic features

Answer 9

delusions, hallucinations, disordered thought

Question 10

What do the following conditions have in common: sleep apnea, hypothyroidism, chronic pain, stroke, heart disease

Answer 10

medical conditions that can cause depression

Question 11

Name some common medication classes that can cause depression

Answer 11

beta-blockers, corticosteroids, benzodiazepine, Varenicline (Chantix)

Question 12

Comorbid psychiatric conditions with depression

Answer 12

anxiety disorders and substance abuse

Question 13

What does DIGFAST stand for?

Answer 13

distractible, impulsive, grandiose, flight of ideas, activities, sleep, talkative

Question 14

What does CAGE stand for?

Answer 14

felt need to Cut down on drinking, annoyed by ppl criticizing your drinking, felt Guilty about your drinking, ever had an Eye opener

Question 15

Hamilton anxiety score that indicates significant anxiety

Answer 15

> 20

Question 16

Name the SSRIs

Answer 16

Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac)

Question 17

First line treatment of depressive disorders. No real differences in efficacy. Difference in side effects and half lives

Answer 17

SSRIs

Question 18

Side effects include: GI disturbance, sexual dsyfxn, anxiety, insomnia/sedation, sweating, dizziness

Answer 18

SSRIs

Question 19

Acts on both serotonin and norepinephrine. Not clearly more efficacious

Answer 19

SNRIs

Question 20

Name the two SNRIs

Answer 20

Venlafaxine (Effexor). Duloxetine (Cymbalta)

Question 21

Indicated for neuropathy

Answer 21

Duloxetine (Cymbalta)

Question 22

Side effects of SNRIs

Answer 22

HTN and tachycardia

Question 23

Name the TCAs

Answer 23

Amitriptyline, Nortriptyline, Clomipramine, Doxepin, Imipramine

Question 24

Side effects include: Anticholinergic, Antihistamine, Orthostatic hypotension, Cardiac

Answer 24

TCAs

Question 25

Why are TCAs not frequently used?

Answer 25

lethal in overdose and more drug-drug interactions

Question 26

Name the two MAOIs

Answer 26

phenelzine (Nardil), tranylcypromine (Parnate)

Question 27

Good for sleep at low doses. If tolerated – functions as an AD at higher doses. Watch for sedation, orthostasis, priapism

Answer 27

Trazodone

Question 28

Uses include: Major Depressive disorder: ADHD: Smoking cessation

Answer 28

Bupropion

Question 29

CI to Bupropion

Answer 29

seizure disorders and bulimia

Question 30

Antidepressant that is safe in pregnancy and can be added on to SSRI to restore libido

Answer 30

Bupropion

Question 31

Used off-label for insomnia | and as appetite stimulant. Good for patients with nausea

Answer 31

Mirtazapine

Question 32

How long does it take at a minimum for medication to be effective?

Answer 32

2-4 weeks

Question 33

What should you do if there is no improvement in patient in 4-6 weeks?

Answer 33

consider switch, increase dose or augmentation

Question 34

Most expensive antidepressant

Answer 34

Duloxetine

Question 35

Population with increased risk of suicide with antidepressants

Answer 35

up to 24yrs old

Question 36

Longer acting benzos with lower abuse potential. Short term use

Answer 36

clonazepam, lorazepam over alprazolam, diazepam