Depressive Disorders, Anxiety Disorders and Bipolar and Related Disorders Flashcards Preview

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Flashcards in Depressive Disorders, Anxiety Disorders and Bipolar and Related Disorders Deck (49)
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What does NE do in the major depressive disorders?

-down regulates beta-receptors; adrenergic function abnormal in depression


What does DA do?

-decreased in depression
-increased in mania



-SSRI's proved effective as anti-depressants


What is the time period for a major depressive disorder?

-2 week period
-must have either 1.) depressed mood, or 2.) loss of interest or pleasure


Time period for a manic episode

-abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week with at least 3 of the things


What is a hypomanic episode?

-similar to manic episode but is less seere
-episodes only need to last 4 days and must not include psychotic features


What are the 4 neurochemical things involved with these diseases?

-Dopamine: we want to try and upregulate this!
-5HT: good anti depressants


What is very important in managing depression?



What are some of the other things that a major depressive episode can have?

-depressed mood most of the day, nearly every day
-markedly diminished interest or pleasure in all, or almost all, activities most of the day nearly every day
-significant weight loss or weight gain when not dieting
-insomnia or hypersomnia
-psychomotor agitation or retardation
-fatigue or loss of energy nearly every day
-feelings of worthlessness or excessive guilt
-diminished ability to think or concentrate
-recurrent thoughts of death or suicide


What was the list of things for a manic episode?

-inflated self esteem or grandiosity
-decreased need for sleep
-more talkative
-flight of ideas/racing thoughts
-distractibility: can't focus on anything
-increased goal-oriented behavior
-excessive involvement in pleasurable activities: they lovvvve taking risks!


What is major depressive disorder?

-diagnosis require the presence of one or more major depressive episodes and the ABSENCE of any manic, hypomanic, or mixed episodes


What is the difference between hypomania and mania?

-with hypo, you dont get thrown in jail, you just annoy your family
-Type 1 bipolar is mania
-type 2 is hypomania


Tx for Major depressive disorder?

-Somatic therapies
-TCAs: nortriptyline, clompramine; amitriptyline, impramine
-MOAI's: selegiline, tranycypromine
-SSRI's: Fluoxetine, parosetine, sertraline, citalopram
-Triazolopryidines: trazodone
-SNRI's (duloxetine)


What is ECT used for?

-tx resistant depression
-short term memory loss common
-induces a seizure
-safe and effective


What is Persistent Depressive Disorder (Dysthymia)?

-depressed mood for most of the day that has not been severe enough to meet criteria for major depressive episode
-during 2 years, cannot be w/o sx for >2 mo at a time


What drug gives you priapism?



What does Bupropion do?

-it like upregulates DA and blocks Serotonin reuptake or something like that
-good for overweight chick who is depressed and has low energy


Which drug has the long ass half life?



What is Premenstrual Dysphoric Disorder? (PMDD)

-mood instability with anxiety, depression, irritability
-occur the week before menses
-consistent pattern over the year


Tx for PMDD?

-exercise, diet, relaxation therapy
-SSRIs: sertraline, fluoxetine, paroxetine


Bipolar 1 disorder

-single manic episode is necessary to diagnose
-At least one manic or mixed episode*****
-+/- major depression but not req. for dx
-Can be psychotic episode
-delusions and/or hallucinations
-Worse prognosis than MDD


What is the essential feature of dperession with seasonal pattern?

-onset and remission of major depressive episodes at characteristic times of the year
-often with change of seasons
-Light therapy
-sleep more and eat more
-most cases, the episodes begin in fall or winter and remit in summer


Bipolar 2 disorder

-pts have had at least one major depressive episode and onehypomanic episode in the absence of any manic or mixed episodes
-More prevalent than BPD-1


Tx for bipolar disorders?

-Mood stabilizers (1st line): lithium, valproic acid
-Second-Generation Antipsychotics


What is Cyclothymic disorder?

-dysthymic disorder with intermittent hypomanic periods
-pt who, over the last 2 years, experiences repeated episodes of hypomania and depression (not severe enough to meet criteria for major depressive disorder)


Tx for cyclothymic disorder

-Mood stabilizing drugs
-Antidepressants frequently precipitate manic symptoms
-Supportive psychotherapy


What do we have to watch with lithium?

-kidney function
-thyroid function


What are the 3 things that you can die from quitting cold turkey?



Generalized aniety

-involved worry about actual circumsances, events, or conflicts
-often accompanies panic anxiety
-Sx of generalized anxiety fluctuate more than those of panic anxiety


What is panic disorder 1

-recurrent unexpected panic attacks