MDD and bipolar II Flashcards Preview

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Flashcards in MDD and bipolar II Deck (54):
1

What is the role of psychotherapy and psychopharmacology?

Complementary--psychopharmacology outcomes are largely improved with psychotherapy

2

What is transcranial magnetic stimulation?

A noninvasive method used to stimulate small regions of the brain. During a TMS procedure, a magnetic field generator, or "coil", is placed near the head of the person receiving the treatment. The coil produces small electric currents in the region of the brain just under the coil via electromagnetic induction. The coil is connected to a pulse generator, or stimulator, that delivers electric current to the coil

3

What is the role of ketamine in the treatment for depression? What is the MOA?

Rapid response

NMDA receptor antagonist

4

What is the role of exercise in MDD?

Treatment, but not cure

5

What is the black box warning for antidepressants?

Increase risk for suicidal ideation if young. Usually occurs in the first 2 weeks

6

True or false: improvements in mood can be seen in the first week of antidepressant therapy

True, but smaller than full effect

7

What is the MOA of duloxetine?

SNRI

8

What is the difference in response vs remission in the treatment of MDD?

-Response = 50% reduction
-Remission = 100%

9

Should you dose antidepressants according to severity of symptoms?

No

10

What are the major TCAs?

Imipramine
Amitriptyline

11

What is the MOA of venlafaxine?

SNRI

12

What is the MOA of desvenlafaxine?

SNRI

13

What is the MOA of levomilnacipran?

SNRI

14

What is the MOA of fluoxetine?

SSRI

15

What is the MOA of fluvoxamine?

SSRI

16

What is the MOA of paroxetine?

SSRI

17

What is the MOA of sertraline?

SSRI

18

Which of the SSRIs can cause QTc prolongation?

Citalopram and escitalopram

19

What is the MOA of SNRIs?

Increase 5HT and NE

20

True or false: there is no such thing as a stronger or weaker antidepressant

True

21

What is the MOA of vilazodone?

SSRI with 5HT1 binding properties

22

What is the MOA of vortioxetine?

SSRI with multiple serotonin properties

23

What is the effect of vilazodone and vortioxetine on weight?

Weight neutral

24

What is the MOA of bupropion?

NE and dopamine reuptake inhibitor

25

What is the MOA of mirtazapine? What is it known for?

Alpha 2 blocker and serotonin blocker

Weight gain (good in cachectic patients)

26

What is the MOA of trazodone?

Inhibition of 5HT2A receptors. Human and animal studies have demonstrated that inhibition of this receptor is associated with antianxiety, antipsychotic and antidepressant effects.

27

What is the MOA of Quetiapine?

Atypical antipsychotic

28

What is methylphenidate?

Ritalin (amphetamine)

29

What is dextroamphetamine?

Adderall

30

Which gender has an increased prevalence in bipolar disorder?

Neither--equally common

31

What percent of patients who have had an episode of bipolar disorder will have another incidence?

90%

32

True or false: there is no increase in the incidence of bipolar disorders in 1st degree relatives of patients with the disorder

False--increased

33

What are the diagnostic criteria for bipolar disorder?

Requires the presence of manic or mixed episode--no depressive episode is required

34

True or false: to be diagnosed with bipolar disorder, you do NOT need to have a depressive episode

True

35

True or false: mania usually requires hospitalization

True

36

Untreated episodes of mania usually last how long?

Few weeks to months

37

What is the mean age of onset for bipolar disorder?

early 20s

38

Do patients with manic episodes typically have insight into their disease?

no

39

What usually precedes episodes of mania with bipolar disorder?

Psychosocial stressors

40

What is a hypomanic episode?

Same s/sx as a manic episode, but less severe, and do not markedly impair functioning

41

What is bipolar I disorder?

One or more manic or mixed episodes (no MDE required)

42

What is bipolar II disorder?

At least one hypomanic episode and at least one depressive episode without any manic or mixed episodes

43

What is cyclothymia?

2 years of fluctuating periods of hypomania and depressive symptoms that don't meet full criteria for a hypomanic or major depressive episode

44

Can anti-depressants cause manic episodes in patients with bipolar disorder?

Classically, yes, but most of the time they just don't respond

45

How efficacious is Li in the treatment of bipolar disorder?

Highly, but narrow therapeutic window

46

What lifestyle change in indicated for bipolar treatment?

Sleep hygiene

47

What is the treatment for manic episodes with bipolar?

Antipsychotics

48

True or false: Li is neuroprotective

True

49

What is the number 1 killer of bipolar patients?

CV disease

50

What is the MOA of phenelzine?

MAOI

51

What is the MOA of selegiline?

MAOI

52

What are the diagnostic criteria for bipolar disorder? (7)

-Flight of ideas
-Inflated self-esteem
-Distractibility
-Goal directed activity increased
-Excessive pleasurable activities
-Talkativity
-Sleep needs decreased

(FIDGETS)

53

How many s/sx are needed from the criteria of bipolar disorder to qualify?

Three, but four needed if only irritable

54

What non-pharmacotherapy treatment is recommended for bipolar disorder?

Good sleep hygiene