Effective Maintenance for Bipolar?
Lamotrigine
Lithium
Quetiapine
Valproate Sodium
NOT Haloperidol! Only for mania but not for maintenance
Serotonin Syndrome
Signs and symptoms?
TX?
- Agitation, confusion, tachy, High BP, dry mouth
2. Stop drug; give Lorazepam or Diazepam
Obsessive Compulsive behavior?
TX?
Repetitive stimuli exposure
Female who lost his husband in a car crash 2 weeks ago.
Unable to sleep; relived the event; refuse to go in a car
DX?
Acute Stress disorder!
Adjustment DO –> Acute Stress disorder –> PTSD ( more than 1 month)
Severity of Anorexia nervosa. Based on What?
BMI
Schizo patient on Haldol
Cannot sit still
DX?
Akathisia
Medication that decreases depressive symptoms in children and adolescence?
- Fluoxetine (Prozac)
Paroxetine is associated with Suicide!
Patient with Post traumatic stress disorder.
TX?
- SSRI or SNRI –> Sertraline or Paroxetine
2. 2nd line: Mirtazapine
Which Antidepressant can prolong QT interval and should be avoided with concomitant QT prolong in agents?
Citalopram + Escitalopram
Patient diagnosed with Somatization disorder.
Most Effective Drug?
TCA and SSRI
Amitriptyline is a TCA that has great success!
Adult Pt with significant depression; no other health problems
Best initial tx?
SSRI: fluoxetine!
Others:
SNRI: Cymbalta
TCA: Amitriptyline
Alpha 2 antagonist: Mirtazapine (remeron)
What is Boarderline Personality DX?
Tx if stable?
Maladaptive personality, highly emotional lability, intense anger, unstable relationship, internal sense of emptiness. Ha self injurious behavior. 1 out of 10 succeeds in vomiting suicide.
Psychotherapy if stable.
Inpatient hospitalization if extreme difficulties in living and daily functioning.
44 y/o female with Obesity, Seizure and now have Depression
Meds?
SSRI or SNRI!
Bupropion (Wellbutrin)-SNRI - good for obesity but CI in Seizure patients!!
