Disorders of Childhood and Adolescence Flashcards Preview

Psychiatry pro +1700 > Disorders of Childhood and Adolescence > Flashcards

Flashcards in Disorders of Childhood and Adolescence Deck (96)
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31

What is the key distinguishing factor for deciding therapy vs medical treatment for MDD?

Severity--psychotherapy first, add drugs if severe

32

What is the MOA of bupropion?

Increased NE and dopamine

33

What are the two SSRIs that are FDA approved in children, and are first line?

Lexapro (escitalopram) and prozac (fluoxetine)

34

Why is it that bupropion is useful for the treatment of ADHD and depression?

Increased NE and dopamine which is similar to amphetamine

35

What doses of SSRIs must be prescribed for OCD (high or lower than for MDD)? How long does this take to take effect for OCD?

Much higher

Takes months to take full effect

36

Neurovegetative s/sx benefit from what particular SSRI?

Fluoxetine

37

What antidepressant has an increased risk of seizures?

Bupropion

38

What is the major adverse effects of SSRIs?

-Disinhibition
-GI bleed

39

Disinhibition with SSRI use is suspicious for what?

Bipolar disorder

40

Which antidepressant has an increase in DBP?

Effexor (venlafaxine)

41

Which antidepressant has an increased risk of GI bleeding? MAO?

Cymbalta (duloxetine) (SNRI)

42

What are the s/sx of serotonin syndrome? (5)

-Fever
-Rigidity
-Autonomic instability
-Psychosis (visual)
-Myoclonic jerks

43

What are the s/sx of discontinuation of antidepressants?

-Dizziness
-HA
-n/v
-Electric shock sensations

44

What percent of MDD in children has severe suicidal ideation?

60%

45

What is the leading cause of disability in the world?

Depression

46

A child with one depressed parent is how many times more likely to have depression?

2x

47

A child with two depressed parent is how many times more likely to have depression?

4x

48

Why must you disclose the black box warning for SSRIs?

Malpractice o/w

49

What is the issue with the black box warning? What were the results of the study that led to this conclusion?

Correlation vs causation

(2% with placebo suicide vs 4% with)

50

What is the probability of having increased suicidal ideation with meds vs without?

With= 4%
Without = 15%

51

When in the course of the depression is the risk of suicidal ideation greatest post antidepressant prescription?

First four weeks

52

The black box warning goes up to what age?

24

53

What has happened to rates of suicide since the black box warning? What about the number of prescriptions?

Suicides have Gone up 20%

Number of prescriptions down 20%

54

What are the five questions that should be asked with suicidal ideation?

1. Plan
2. Means / access
3. Intent
4. Homicidal
5. Previous attempts

55

What is the issue with contracts for safety?

Still liable for anything that happens

56

What is the role of family history of suicide in determining the risk for suicide?

Risk factor

57

What is a major warning sign for suicidality?

Getting significantly better in a short period of time--may point to suicidal ideation

58

True or false: childhood bipolar disorders tend to be less severe than adult onset

False--more severe

59

What are the characteristics of childhood bipolar disorders as compared to adults? (2)

-Non-episodic course
-Mixed with *rapid* cycling

60

What is the usual initial episode of bipolar disorder in children: depression or mania?

Depression