Flashcards in MDD and bipolar II Deck (54):
What is the role of psychotherapy and psychopharmacology?
Complementary--psychopharmacology outcomes are largely improved with psychotherapy
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
What is the role of ketamine in the treatment for depression? What is the MOA?
NMDA receptor antagonist
What is the role of exercise in MDD?
Treatment, but not cure
What is the black box warning for antidepressants?
Increase risk for suicidal ideation if young. Usually occurs in the first 2 weeks
True or false: improvements in mood can be seen in the first week of antidepressant therapy
True, but smaller than full effect
What is the MOA of duloxetine?
What is the difference in response vs remission in the treatment of MDD?
-Response = 50% reduction
-Remission = 100%
Should you dose antidepressants according to severity of symptoms?
What are the major TCAs?
What is the MOA of venlafaxine?
What is the MOA of desvenlafaxine?
What is the MOA of levomilnacipran?
What is the MOA of fluoxetine?
What is the MOA of fluvoxamine?
What is the MOA of paroxetine?
What is the MOA of sertraline?
Which of the SSRIs can cause QTc prolongation?
Citalopram and escitalopram
What is the MOA of SNRIs?
Increase 5HT and NE
True or false: there is no such thing as a stronger or weaker antidepressant
What is the MOA of vilazodone?
SSRI with 5HT1 binding properties
What is the MOA of vortioxetine?
SSRI with multiple serotonin properties
What is the effect of vilazodone and vortioxetine on weight?
What is the MOA of bupropion?
NE and dopamine reuptake inhibitor
What is the MOA of mirtazapine? What is it known for?
Alpha 2 blocker and serotonin blocker
Weight gain (good in cachectic patients)
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.
What is the MOA of Quetiapine?
What is methylphenidate?
What is dextroamphetamine?
Which gender has an increased prevalence in bipolar disorder?
What percent of patients who have had an episode of bipolar disorder will have another incidence?
True or false: there is no increase in the incidence of bipolar disorders in 1st degree relatives of patients with the disorder
What are the diagnostic criteria for bipolar disorder?
Requires the presence of manic or mixed episode--no depressive episode is required
True or false: to be diagnosed with bipolar disorder, you do NOT need to have a depressive episode
True or false: mania usually requires hospitalization
Untreated episodes of mania usually last how long?
Few weeks to months
What is the mean age of onset for bipolar disorder?
Do patients with manic episodes typically have insight into their disease?
What usually precedes episodes of mania with bipolar disorder?
What is a hypomanic episode?
Same s/sx as a manic episode, but less severe, and do not markedly impair functioning
What is bipolar I disorder?
One or more manic or mixed episodes (no MDE required)
What is bipolar II disorder?
At least one hypomanic episode and at least one depressive episode without any manic or mixed episodes
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
Can anti-depressants cause manic episodes in patients with bipolar disorder?
Classically, yes, but most of the time they just don't respond
How efficacious is Li in the treatment of bipolar disorder?
Highly, but narrow therapeutic window
What lifestyle change in indicated for bipolar treatment?
What is the treatment for manic episodes with bipolar?
True or false: Li is neuroprotective
What is the number 1 killer of bipolar patients?
What is the MOA of phenelzine?
What is the MOA of selegiline?
What are the diagnostic criteria for bipolar disorder? (7)
-Flight of ideas
-Goal directed activity increased
-Excessive pleasurable activities
-Sleep needs decreased
How many s/sx are needed from the criteria of bipolar disorder to qualify?
Three, but four needed if only irritable