Antidepressant Pharmacotherapy Flashcards

1
Q

median age for depression

A

30 years

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2
Q

leading cause of disability ages 15-44 and worldwide

A

mental illness

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3
Q

 10 million or 4.2% of adults

A

 10 million or 4.2% of adults

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4
Q

Suicide stats

A

 10th leading cause of death in the U.S.
 the 3rd leading cause of death for people aged 10–24
 2nd leading cause of death for people aged 15–24

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5
Q

for about 50% of indviduals mental illness manifests by

A

14 years

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6
Q

women have

A

twice the rate of depression than men do

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7
Q

what ethic group has lowest incidence of depression

A

asain men

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8
Q

Conditions associated with MH Illness

A
Hypothyroidism
 Dementia, stroke
 Rheumatoid arthritis
 CHF, MI
 Vitamin B-12 deficiency
 Cancer
 Parkinson’s Disease
 DM
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9
Q

Drugs associated with MH illness

A
 Alcohol/Substance use
 Antihypertensives
 Antiparkinsonian agents
 Hormonal preparations
 Anticancer agents
 Psychotropic agents
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10
Q

Risk Factors for Depression first four

A

 Prior episode of depression
 FMH of mood disorders
 Prior suicide attempt
 Current substance abuse

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11
Q

risk factors for depression last three

A

 Medical neurological comorbidity
 Lack of social support
 Stressful life events

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12
Q

DSM-5 depression dx critera

A
One or both for 2 weeks:
 Depressed, irritable mood
 Loss of interest or pleasure
AND 3-4 of the following symptoms:
 Change in weight/appetite
 Change in sleep pattern
 Agitated/restless
 Fatigue/loss of energy
 Feelings of worthlessness or guilt
 Difficulty with concentration of memory
 Frequent thoughts of death or suicide
 Classification of Depression
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13
Q

History and assessment first four

A
 Identify presenting symptoms
 Establish the course of the illness
 Obtain: PMH and medication history, FMH, psychosocial
history
 Assess physical status
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14
Q

History and assessment last three

A

 Establish psychological baseline
 Assess for suicidality/thoughts of harm
 Obtain laboratory baseline

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15
Q

Mood disorders =

A

neurotransmitter deficiency

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16
Q

neuortransmitters

A

serotonin (5ht)
dopamine
norepinepherine

17
Q

Examples of mood disorders

A

Major depression
 Dysthymia
 Bipolar I Disorder
episodes sustained mania; often depression
 Bipolar II Disorder
1 or more major depressive episodes; at least 1 episode of hypomania
 Minor Depression

18
Q

baseball approach to neurotransmitter selectivity

A
1st base serotonin 5ht
2nd base 5h2a
3rd base 5ht3
home plate NE
Pitcher DA
19
Q

5HT reuptake inhibitor

A

increases synaptic serotonin

20
Q

5HT2A

A

Decreases sleep, Decreases libido

21
Q

5HT3

A

Nausea/GI upset

22
Q

NE

A

Decreases Lethargy

23
Q

DA

A

Increases attention

Decreases Addiction/Craving

24
Q

NE only effects

A

Vigilance
Concentration
Motivation
Interest

25
Q

Serotonin Only effects

A

Impulsivity
Sex
Appetite
Agression

26
Q

NE and Serotonin effects

A
Mood
Emotion
Anxiety
Pain
Irritability
Cognitive Function
27
Q

Serotonin Residual Symptoms

A
  • Anxiety
  • Inhibited communication
  • Dysfunctional attitude
  • High neuroticism
  • ∗Social maladjustment
  • ∗Insomnia
  • Psychic and somatic anxiety
  • Guilt and lowered self-esteem
  • Hopelessness
  • Impaired work and interests
  • Psychosocial disability
  • Sexual symptoms
  • Anhedonia
  • Lack of motivation
28
Q

NE residual related symptoms

A
•∗Excessive reactivity to social
stress
•Fatigue
•Interpersonal friction
•Irritability
29
Q

Dompamine Related residual symptoms

A

•Cognitive Impairment •Anxiety Fatigue

30
Q

Look before you LEAP

A
 Libido
 Energy
 Attention/Addiction
 Points to Ponder
 Things you should know about medications