Mental Health

Question 1

Examples of atypical antipsychotics

Answer 1

Quetiapine
Olanzapine
Risperidone
Clozapine

Question 2

Indication of atypical antipsychotics

Answer 2

Schizophrenia
Bipolar disease

Question 3

Side effects of atypical antipsychotics - 4 general and 1 each for respiradone and clozapine

Answer 3

Better tolerated than typical antipsychotic
Weight gain
DM
Lipid changes
Arrhythmia

Risperdione - breast symptoms and sexual dysfunctions

Clozapine -agranulocytosis

Question 4

Contraindications of atypical antipsychotics

Answer 4

Caution in cardiovascular disease
Clozapine must not be used in severe heart disease or people with hx of neutropenia

Question 5

Key interaction of atypical antipsychotics -5

Answer 5

Antiemetics
Amiadrone
Quinine
Macrolides
SSRI

Question 6

Monitoring atypical antipsychotics

Answer 6

Prolactin concentration should be measured at the start of therapy at six months and then yearly

Monitor body weight lipid profile and passing blood glucose at baseline and intermittently during treatment

Question 7

Examples of typical antipsychotics

Answer 7

Haloperidol
Chlorpromazine
Flupentixol

Question 8

4 indication of typical antipsychotics

Answer 8

Rapid tranquillisation
Schizophrenia
Bipolar disorder
Nausea and vomiting (particularly in palliative care setting )

Question 9

Side effects of typical antipsychotics

Answer 9

Acute dystonic reaction
Akathisia
Neuroleptic malignant syndrome
Tradive dyskinesia
Drowsiness
Hypotension
Qt prolong
Erectile dysfunction
Hyperprolactinaemia

Question 10

Monitoring for typical antipsychotics

Answer 10

Prolactin concentration should be measured at the start of therapy at six months and then yearly

Question 11

Examples of SSRI

Answer 11

Sertraline
Citalopram
Fluoxetine
Escitalopram

Question 12

3 indications of SSRI

Answer 12

First line for depression
Panic disorder
OCD

Question 13

MOA of SSRI

Answer 13

SSRIs preferentially inhibit neuronal reuptake of serotonin from the synaptic cleft, thereby increasing its availability for neurotransmission

Question 14

Side effects of SSRI

Answer 14

Change in appetite
Weight change
Skin rash
Hyponatraemia
Prolong qt

Question 15

Contraindications of SSRI

Answer 15

Caution in epilepsy, PUD
In young people it is associated with suicidal ideation
Dose reduction in hepatic impairment

Question 16

Key interaction of SSRI

Answer 16

Avoid with :
Monoamine oxidase inhibitor
Other serotonergic drugs e.g tramadol
Gastro protection considered if taking with anticoagulants aspirin or nsaids

Question 17

Monitoring for SSRI

Answer 17

Reviews 1-2 weeks after starting
Should continue for at least 6 months after resolution of symptoms

Question 18

Indication of lithium

Answer 18

Treatment and prophylaxis of mania bipolar disorder recurrent depression or aggressive and self harming behaviour.

Question 19

Contraindications of lithium

Answer 19

Advanced renal failure
Addisons disease
Low sodium diet
Untreated hypothyroidism
Caution in breastfeeding and pregnancy

Question 20

Key interaction of Lithium -4

Answer 20

Thiazide diuretics, ACEi and NSAIDs, and CCB

Question 21

Side effects of lithium

Answer 21

Very common- GI disturbances , Polyuria, polydipsia, and fine tremor and metallic taste
Common – fluid retention and hypothyroidism
Rare but important – kidney failure, palpitations and blurred vision

Question 22

Monitoring for lithium

Answer 22

every four weeks, then weekly from 36 week due to its narrow therapeutic window
Renal function
Thyroid functions