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Flashcards in Mood Disorders Deck (20):
1

Lyme Disease

can cause problems with cog. fxn and mood changes might be the first sx
- give 2-3 weeks of Doxy

2

Bio changes in Depression

Dec metabolism of anterior frontal lobe
elevated HPA
Dec lymphocytic prolif
INCR REM sleep and core body temp

3

Lithium Side Effects

Weight gain
Acne/skin changes
hypothyroid
polyuria
metallic taste

4

Tx of Choice - Dysthymia

Venlafaxine or Bupropion
MAOI

5

Post partum blues frequency/timeline

30-75% get it (avg 50%)
- starts in 3-5 days PP
- lasts days to weeks, resolves on its own
- NO ANHEDONIA ==> this is Post-partum DEPRESSION

6

depression post stroke

higher risk of depression in post-stroke for up to 2 years, 8x INCR risk of mortality

7

Sleep Deprivation in Depression vs Mania

can help in depression
can trigger mania - college student who gets acutely manic during finals --> give long acting BZD (clonazapem)

8

Seasonal Affective d/o

similar to atypical depression in that INCR sleep and INCR weight gain, remits by sprint time
- carb craving
- lasts about 5-6months
- trigger is the shortened daylight
- Tx w/ light therapy and SSRI

9

Acute Depressive Episode in stable Bipolar

on top of Lithium start a antidepressant
-anti-dep triggered mania seen in about 30% so start low, and taper off once the depression is gone
- some anti-dep may cause rapid cycling
-start w/ bupropion

10

Cyclothymia

recurrent mild depression + hypomania
- persists for 2 years (AT LEAST)
- 1 year for children/teens
- sx-free intervals are NEVER longer than 2months
- starts in teenage years/early adult and is chronic
- ddx includes borderline or substance abuse

11

PMDD

starts 1 week before menses
HA, irritability, emo lability
other sx include edema, breast pain, weight gain
- tx include short course of SSRI +/- analgeis or diuretics

12

most common complaints after ECT

HA
muscle soreness
nausea

13

Lithium Monitoring Timeline

initially check plasma Li level every 1-2months
Thyroid fxn
creatinine
UA
if patient is OVER 50y --> ECG (cardiac)

14

bereavement vs MDD

marked functional impairment
thoughts of death OTHER than id be better of dead without loved one
hallucinations OTHER than hearing loved one calling them

15

childhood depression

SSRI works, TCA doesnt
sx diff from adult (socially withdrawn, irritable, worsening grades, no interest in friends etc)
1/3 --> will develop bipolar
auditory hallucinations common (mood congruent)

16

MDD/Refractory MDD augmentation strategies

ADD LITHIUM
or add thyroid hormone, stimulant, estrogen , light therapy

17

ECT CONTRA-indications

MI in past 4 weeks
space occupying lesions
INCR ICP
Aneurysms
Bleeding D/o
any condition that disrupts BBB (meningitis?)

18

melancholic depression

Anhendonia of ALL activities
nothing makes them feel better
weight loss
intense guilt
early morning awakening
psychomotor retardation
- Tx of Choice --> TCA's

19

Double depression

is MDD on top of dysthymia
- INCR risk of suicide
- more severe depressive sx
- more psychosoc impairment
- more tx resistance

20

Atypical depresson

feel better in morning (reverse of MDD)
self-pity
improved mood with some pleasurable events
excess sensitivity to rejection
MAOI's = more effective