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Flashcards in Depression Deck (33)
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1
Q

what is the depression scale most widely used

A

HDRS or Ham-D

2
Q

What is the DSM-5 of depression

A
at least five of these
Mood-depressed
Sleep-increased/decreased
Interest/pleasure-diminished
Guilt or feeling of worthlessness
Energy-Decreased
Concentration-Decreased
Appetite-increased or decreased
Psychomotor agitation or retardation
Suicidal ideation
"M SIG E CAPS"
3
Q

Use of BZD in depression

A

used when anxiety is also present

do not use alone will mask depression

4
Q

Drugs that worsen depression

A
ADHD medications
indomethacin
Antiretrovirals
Beta-blockers
hormones
5
Q

list MAOI

A

phenelzine
tranylcypromine
isocarboxyazid

6
Q

which drug doesn’t need to be tapered off since it self-tapers due to a long half-life

A

fluoxetine

7
Q

how long to trial an antidepressant before concluding it doesn’t work

A

6-8 weeks

8
Q

preferred antidepressants to use in pregnancy

A

SSRIs

-no paroxetine-cardiac effects

9
Q

preferred antidepressant to use in post-partum depression

A

SSRIs
Tricyclics
-not doxepin

10
Q

Which symptoms improve first with antidepressants

A

physical symptoms take a few weeks

psychological symptoms take a month or more

11
Q

List SSRIs (5)

A
citalopram
escitalopram
fluoxetine
paroxetine
sertraline
12
Q

Major warnings for SSRIs

A

QT prolongation
SIADH
hyponatremia
bleeding

13
Q

SE of SSRIs

A

sexual side effects: decreased libido

14
Q

What is the most activating SSRI “energy”

A

fluoxetine

15
Q

What is the most sedating SSRI “tired”

A

paroxetine

16
Q

what SSRI is preferred in patients with cardiac risk

A

sertraline

17
Q

list SNRIs (3)

A

venlafaxine
duloxetine
desvenlafaxine

18
Q

What is the max dose of citalopram to prevent QT prlongation

A

40mg

19
Q

Tricyclics MOA

A

inhibit NE and 5HT reuptake also block ACh and histamine receptors
Secondary amines: more selective for NE
Tertiary amines: more effective and worse SE

20
Q

List tertiary amines (TCAs)

A

amitriptyline
doxepine
clomipramine
imipramine

21
Q

SE of TCAs

A

QT prolongation
orthostasis
Anticholinergic SE
weight gain

22
Q

List Secondary amines (TCAs)

A

nortriptyline

desipramine

23
Q

List DNRIs

A

buproprion

24
Q

Contraindication for buproprion

A

seizure disorder

history of bulemia/anorexia

25
Q

MOA of MAOis

A

inhibit the enzyme monoamine oxidase which breaks down catecholamines including 5-HT, NE, EPI, and DA if these NTs increase dramactically hypertensive crisis and death can result

26
Q

What foods to avoid in MAOIs

A

tyamine-rich

  • aged cheese
  • pickled herring
  • yeast extract
  • air-dried meat
  • sauerkraut
  • soy sauce
27
Q

How to avoid hypertensive crisis and serotonin syndrome

A
2 week wash-out period b/w MAOI and
-SSRI
-SNRI
-TCAs
-Bupropion
5-week washout when changing from 
-fluoxetine to MAOI
28
Q

What anti-depressant to use to avoid weight gain

A

bupropion

-avoid mirtazepine

29
Q

What anti-depressants to use and not use with cardiac issues

A

use: sertraline
avoid: citalopram, escitalopram

30
Q

What anti-depressant to use for depression with pain

A

duloxetine

31
Q

Treatment options for treatment resistant depression

A

aripiprazole
quetiapine
olanzapine/fluoxetine

32
Q

ability SE

A

anxiety
insomnia
akasthisia

33
Q

SE of olanzapine

A

sedation
weight gain
increase lipids
increase glucose