depression part 2

Question 1

premenstrual dysphoric disorder pathogenisis:

Answer 1

-abn. response to normal cyclic progesterone changes such as interaction w receptors:

-serotonin
-GABA
-Beta endorphins

Question 2

Premenstrual Dysphoric Disorder DSM-5:

Answer 2

A. majority of menstrual cycles atleast 5 SX are present the week before or onset of menses or go away after menses

B. one or more :
-marked affective lability
-irritable
-marked depressed mood, feelings of hopelessness
-marked anxiety

C. basically the dsm 5 for mdd

Question 3

treatment of depression

Answer 3

-pharmacological
-non pharmacologic tx:
-counsel, work out, sleep
-F/u

Question 4

antidepressants classes:

considerations:

Answer 4

-SSRI
-SNRI

-reduce dose if hepatic/renal dx

Question 5

dont use SSRI/SNRI if :

Answer 5

dont use if pts are on:

-anticoag
-appetite suppressants
-5HT agonists for migraines

-DO NOT USE PAOXETINE IF CONSTIPATION

Question 6

factors that influence medication choice

Answer 6

-pt. preference
-pt. history of family on that med
-overdose pot.
-cost
-gender

Question 7

which drug has minimal risk during breastfeeding?

Answer 7

-sertraline
-paroxetine

Question 8

what are some effective ways to manage depression?

Answer 8

-set goals
-sleep hygiene[ melatonin, trazadone]

Question 9

serotonin syndrome:

sx:

Answer 9

excess serotonin doses: improper SSRI switching

sx: siezures, arrythmias, HYPERthermia, HTN

Question 10

when to refer to psychiatric:

Answer 10

-tx resist
-suicidal ideation
-psychotic sx
-substance disorder
-neuromodulation
pt request

Question 11

ketamine uses:

Answer 11

U: -sedation, antidepressant

short acting antidpressant effects

Question 12

specific therapies for :

dysthymia

premenstrual dysmorphic:

Answer 12

resistant to tx

-excercise, hydrate, stress reduction, COC, ssri

Question 13

specific therapies for :
prolonged disorder

adjustment disorder

Answer 13

-behavioral disorder

-remove identifiable stressor