Flashcards in Psych Deck (32):
Major Depression requirements for dx
2 weeks with 5 or more symptoms of SIGECAPS if anhedonia or depressed mood
Sleep, interest, guilt, energy,, concentration, appetite, psychomotor (leaden paralysis or antzy), suicide
True or false, hyperparathyroidism can cause depression?
Yes, think calcium and psychiatric overtones
Dopamine blockers canc ause depression
Like metaclopramide, prochlorperazine, haloperidol
Med used for viral hepatitis that causes depression?
Atypical depression is what?
Responds to MAOi's (though SSRI is first line)
Peripartum depression is up to 4 weeks later. Psychotic features can happen b/c of depression
Important to differntiate mood disorder secondary to pyschoses and schizoaffective
Persistent depressive disorder
2 years or longer without 2 months without symptoms.
Need depressed mood plus 2 SIGECAPS
Desvenlafaxine, duloxetine, milnacipran, venlafaxine are what?
SNRIs and dizziness, serotonin syndrome, SEX DYSFUNCITON!
Serotonin syndrome sx?
Mental status change, autonomic excitation, neuromuscular hyperactive, OCULAR CLONUS
Drugs that increase risk of serotonin. ESPECIALLY the antibiotic
SSRI, SNRI, MAOIs, St johns, tryptophan (precursur)
Tx of serotonin syndrome?
Supportive and vitals
Benzos for sedation
If temp above 41, PARALYZE and mechanically cool
If still agitated, use cyproheptadine
What is cyproheptadine used for?
Still agitated after bento given after serotonin syndrome
it is serotonin antagonist
Neuromalignant syndrome vs Serotonin syndrome?
NMS is gradula onset and rigidity wearas 5HT is hyperkinesis and clonus
both have autonomic instability, hyperthermia and muscle problems
what is nice about it?
Bad about it? (contraindications)
weight loss, keeps awake, NO SEXUAL DYSFUNCTION
Lowers seizure threshold
Mirtazapine mechanism. Side effect?
Alpha 2 blocker, so more adrenergic.
Causes sedation and wt gain
Cardiotoxic, tachy, hypotension
CNS toxic (coma, seizure)
Tx of TCA overdose?
BENZOS IF SEIZURE
Depression refractory, psychotic depression, severe suicidality, mania, psychosis, rapid response required...
What does bipolar II disorder need for dx?
Major depressive and at least one hypomanic episode
Manic episode requires what for dx?
3 symptoms of DIG FAST
Impair funcitoning or require hospitalization or psychotic feature
Does hypomania impair functioning or cause psychosis?
Anticonvulsants (If renal failure)
Atypical antipsychotics added if above don't work
ECT could be done
Depression history should be sure to look for episodes of mania.
B/c SSRI could send to mania
Tx for Neph Diabetes Insip if needing lithium?
HCTZ and amiloride b/c amiloride blocks sodium channels that allow sodium into renal cells
Ebstein anomoly is what?
Tricuspid into RV. RV hypoplasia, Regurg. Patent Foramen ovale
Lithium side effects?
Movement Metallic taste
Nephrogen Diab Insip
hypOthyroid (or any thyroid issue)
Preggers issue (ebstein)
Cyclothymic disorder is what?
2 years of hypomanic or depressive symptoms going back and forth
Tx mood stabilizers and psychotherapy (like mini bipolar!)
Dissociative identity disorder
Id is multiple personalities/identities
Depersonaliztion is detachment from body
Derealization is feelings things around aren't real )in a dream state)
Panic disorder dx when?
4 symptoms causing panic attack
THEN MALADAPTIVE behavior of fear of them. Worry at least one month
Benzos to stop acute panic attack (bentos can cause rebound)
GAD Dx: LENGTH OF TIME?
Deression and anxiety same monkey in different shirt
Worry happening more days than not for 6 months with at least three symptoms!
SSRI, SNRI or BUSPIRONE
CBT can help
Social anxiety tx?
Must be interfering or worrying about them
CBT, SSRI, SNRI
Benzo and Beta blockers may help for performance.