Mood Disorders (Depression) Flashcards
(18 cards)
What are risk factors for depression?
- female
- chronic disease or medical comorbidity
- family history
- prior depression
- abuse
- lack of social support
- stressful life events
- substance use
- economic difficulty
What causes depression?
- genetic factors?
- related to neurotransmitters?
- hormones?
- immune response?
What is the diagnostic criteria for major depressive disorder?
- depressed mood or loss of interest/pleasure (anhedonia) in all activities for at least two weeks
AND 4 of:
- change in appetite
- change in concentration
- change in energy
- psychomotor agitation or retardation
- excessive guilt or feelings of worthlessness
- suicidal ideation
What is dysthymic disorder?
a milder form of major depressive disorder
What nursing diagnoses might a patient with depression have?
- disturbed sleep
- imbalanced nutrition
- fatigue
- ineffective coping
- risk suicide
Other than medications, what interventions can be helpful for patients with depression?
- proper nutrition
- proper sleep
- exercise
- electroconvulsive therapy (ECT)
- phototherapy
- cognitive behavioural therapy (CBT)
What differences might you note in children who have depression?
- more likely to have irritated, instead of sad mood
- high risk of suicide
- more likely to have psychosis with auditory hallucinations
What categories of drugs are used to treat depression? List in order of preference.
- selective serotonin re-uptake inhibitors (SSRIs)
- atypical antidepressants- cyclic antidepressants
- monoamine oxidase inhibitors
What is an example of an SSRI? What does this drug do?
- sertraline (Zoloft)
- inhibit reuptake of serotonin to increase levels of serotonin
What is an example of a MAOI? What does this drug do?
- phenelzine (Nardil)
- inhibits MAO to increase neurotransmitters in CNS
What is an example of an atypical antidepressant?
- venlafaxine (Effexor)
What is an example of a cyclic antidepressant? What does this drug do?
- imipramine (Tofranil)
- inhibits reuptake of serotonin and norepinephrine
Which categories of antidepressants would you avoid giving to a patient with a higher risk of suicide and why?
avoid using cyclic antidepressants and MAOIs - they have a narrow therapeutic window
What are side effects of SSRIs?
- serotonin syndrome
What are side effects of MAOIs?
- sedation, dry mouth, constipation, weight gain
- hypertensive crisis may occur if you eat foods with tyramine (aged cheese, beer, red wine, chocolate…)
- lethal in overdose
What are side effects of cyclic antidepressants?
- sedation, dry mouth, weight gain
- narrow therapeutic range
When are atypical antidepressants used?
work well for atypical depression (increased appetite, mood increases in response to positive events, hypersomnia)
What is serotonin syndrome?
caused by accumulation of serotonin
can occur with SSRIs, DO NOT take MAOIs and SSRIs within 14 days of each other
- change in mental status
- agitation
- ataxia (loss of control of body movement)
- myoclonus (spasmodic, jerky movements)
- hyperreflexia
- fever, shivering, sweating
