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40 Cards in this Set

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What is the definition of mood disorders?
primary disturbance in mood causing subjective distress and occupation or social problems
What are the different types of mood disorders?
• major depressive disorder
• bipolar I & II disorders
• dysthymic disorder
• cyclothymic disorder
What are psychosocial causes of depression?
• loss of a parent in the first decade of life
• loss of hope
• low self-esteem
• misinterpretation of life events
• social loss during adult life
What are medical conditions associated with depression?
• cancers
• endocrinologic abnormalities (ex. thyroid, Cushing's)
• infectious disease (ex. PNA, influenza, mono, HIV)
• neurologic illness (ex. Parkinsons, MS, strokes)
• nutrition deficiency
• prescription drugs (ex. methyldopa, propanolol, reserpine, steroids)
• renal & cardiopulmonary disease
What are psychiatric conditions associated with depression?
• anxiety disorders
• drug & alcohol abuse and withdrawal
• eating disorders
• schizophrenia
What are different classes of drugs used to treat depression?
• heterocyclic (or Tricyclic) antidepressants
• Monoamine Oxidase Inhibitors (MAOIs)
• SSRIs
• other
List examples of heterocyclic antidepressants
• Amytriptyline (Elavil)
• Clomipramine (Anafranil)
• Desipramine (Norpramin)
• Imipramine (Toffranil)
Which heterocyclic is used in depression with insomnia?
Amytriptyline (Elavil)
Which heterocyclic is used for obsessive-compulsive disorder?
Clomipramine (Anafranil)
Which heterocyclic is used for depression in the elderly, anorexia, and bulemia?
Desipramine (Norpramin)
Which heterocyclic is used to treat panic disorder with agoraphobia, enuresis, anorexia, and bulemia?
Imipramine (Toffranil)
List examples of SSRIs
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
Which class of antidepressants can be used to treat OCD, premature ejaculation, and panic disorder?
SSRIs
List examples of MAOIs
• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Tranylcypromine (Parnate)
Which class of antidepressants are used for atypical depression, panic disorder, eating disorder, & pain disorder?
MAOIs
List OTHER examples of antidepressants
• Alprazolam (Xanax)
• Amoxapine (Asendin)
• Bupropion (Wellbutrin)
• Nefazodone (Serzone)
Which antidepressant is used to treat anxiety with depression features?
Alprazolam (Xanax)
Which antidepressant is used to treat depression with psychotic features?
Amoxapine (Asendin)
Which antidepressant is used when a patient has intolerance to other antidepressants?
Nefazodone (Serzone)
Which antidepressant is used for the elderly and to help quit smoking?
Bupropion (Wellbutrin)
What are major side effects of heterocyclics?
• anticholinergic effects
• cardiovascular effects (orthostatic hypotension)
• sedation
• weight gain
True/False: Antidepressants can be used for immediate treatment of acute depression
• all antidepressants take 3-6 weeks to work
• The correct answer is: False
What are major side-effects of SSRIs?
• activation and insomnia
• anticholinergic effects
• cardiovascular effects
• causes minor weight gain
• particularly delayed orgasm in men
• sexual problems
What are major side-effects of MAOIs?
hypertensive crisis with ingestion of tyramine-rich foods (ex. aged cheese, beer, wine)
Electroconvulsive therapy involves the induction of generalized seizures lasting 25 to 60 seconds. What are indications for using ECT?
• used i nmajor depressive disorder refractory to antidepressants
• used when rapid resolution of symptoms is needed (because of suicide risk)
What is a major adverse effect of ECT?
amnesia (usually remits within 6 months)
What is a contraindication for ECT?
increased ICP
What is bipolar disorder?
has episodes of both mania and major depression
Differentiate between bipolar I and bipolar II
• Bipolar I: patient has major depression followed by mania
• Bipolar II: patient has major depression followed by episode of hypomania
What is the DOC of the manic phase of bipolar?
Lithium
Which disorder has a worse prognosis, bipolar or major depressive disorder?
bipolar disorder
What is dysthymic disorder?
• involves mild depression most of the time with no discrete episodes
• a constant depression
What is cyclothymic disorder?
involves episodes of hypomania as well as mild depression
How long do symptoms have to be present to be classified as either dysthymic or cyclothymic?
at least 2 years
A common differential diagnosis of dysthymic disorder is bereavement or adjustment disorder. How can you differentiate between dysthymic and bereavement or adjustment disorder?
unlike dysthymic disorder, both bereavement or adjustment disorders have a clearly identifiable life stress that precipitate the depressive symptoms
Differentiate between major depressive disorder and dysthymic disorder
• major depressive: episodic and severe
• dysthymic: non-episode/chronic, less severe, never associated with psychosis
What is the most common age of onset for cyclothymic disorder?
15-25 years old
Dysthymic disorder is more common in which gender?
female (2-3 times more common)
Cyclothymic disorder is more common in which gender?
cyclothymic disorder is seen equal in both
What are the 2 most effective psychological treatments for dysthymic disorder?
• cognitive therapy
• insight-oriented psychotherapy