GP ILA 5: Flat mate

Question 1

Bereavement counselling:

a) Charity
b) NHS support

Answer 1

a) CRUSE

b) None

Question 2

Section 2: treatment

Answer 2

Patient must consent to the treatment (can’t be treated against their will)

Question 3

Section 2: HCPs required

Answer 3

1 section 12 approved doctor
1 doctor known to the patient
1 AMHP

Question 4

Section 4: requirements

Answer 4

Suffering from mental disorder
For protection of patient/others
There isn’t enough time for a 2nd doctor to attend

Question 5

Sertaline/citalopram vs. fluoxetine vs. paroxetine

Answer 5

Paroxetine - very short half life (risk of crash if missed dose), Fluoxetine - very long.

Question 6

Antidepressant for pregnancy

Answer 6

Sertraline has lowest concentration in breastmilk

• Citalopram/fluoxetine have higher concentration
• Avoid: lithium, valproate, carbamazepine, clozapine

Question 7

SSRI side effects (SSSSSS)

Answer 7

o Sexual dysfunction (reduced libido, delayed ejaculation, perineal numbness, ED)
o Suicidality (initial)
o Size (weight gain)
o Stomach upset (diarrhoea, N and V, gastritis)
o Sleep difficulties
o Serotonin syndrome

Question 8

FIbromyalgia management

Answer 8

SSRI or graded exercise