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