Flashcards in Quiz Deck (36)
What are the starting doses of SSRIs?
What are the starting doses of SNRIs?
What is the starting dose of mirtazapine?
What is the starting dose of wellbutrin?
What is the duration of MDD therapy?
What is the diagnostic criteria for MDD?
What are the sx of MDD?
Interest (loss of interest/pleasure)
Guilt (feeling of worthlessness; excessive/inappropriate guilt)
Energy (Fatigue/loss of energy)
Appetite (change in appetite/wt)
What is the diagnostic criteria for mania?
Or any duration if hospitalization is necessary
Cause marked impairment
What is the diagnostic criteria for hypomania?
4+ consecutive days
Not severe enough to cause marked impairment
What are the sx of mania/hypomania?
Grandiose; increase self-esteem
Increased activity (goal directed/highly risky)
Distractibility; flight of ideas
Need less sleep
What are the diagnostic criteria for rapid cycling?
4+ mood episodes (MDD, manic, mixed, hypomanic)/year
What are the criteria for cyclothymia?
Numerous periods with hypomanic sx and depressive sx for at least 2 years that do not meet criteria for MDD
For more than 2 months at a time
Present for at least 1/2 the time
What is the criteria for mixed BD?
Patient w/sx of both mania and depression simultaneously
What are the characteristics of BP I?
Psychosis often present
Hospitalization often required
Duration = months
What are the characteristics of BP II?
Psychosis often not present
Slightly impaired to improved functioning
Hospitalization not required
Duration = weeks
What are the first line therapy for MDD?
What are the first line therapy for acute mania?
Consider 2 drug combination, if severe (MS + SGA)
CBZ 1st or 2nd line depending on guideline
What are the first line therapies for BD?
What are the first line therapies for Mixed BD?
What length of time is considered an adequate trial before adjusting/augmenting MDD therapy?
What do we do if a patient with MDD is non-responsive to therapy?
Change/switch to a drug in a different/same class
What do we do if a patient with MDD is partially responsive to therapy?
Ensure optimized dose
Augment/adjunctive therapy should target remaining sx
Augmentation is better strategy when response is seen
What is the gold standard for augmentation in partial response for MDD?
What drugs are options for MDD augmentation/adjustments?
AAP (low dose SGAs in MDD w/o psychosis)
Where is psychostimulants in MDD partial response therapy?
May consider short course if severe depression (fatigue, not getting out of bed or if immediate response required)
May exacerbate anxiety
What is the DOT of MDD?
12 months with the first episode for most patients
12-26 months for patients w/recurrent and/or severe MDD
Potentially indefinitely depending on severity
What is the DOT of BD?
Which medication decreases SI in MDD?
Which screening tool in MDD is used for screening?