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Major Depression

Test #1

QuestionAnswer
Affective behaviors Dispair, decreased interest in pleasure
Cognitive behaviors crying, negative views
Behavioral behaviors fatigue, sleep disturbances
diagnosing major depression must be in a depressed mood OR have loss of interest in pleasure ALONG WITH 4 other symptoms (total of 5 symptoms)
REM have longer periods of REM sleep
Hormones linked to depression-could be responsible for decreased apetite, weight loss, libido, GI disorders, mood swings
Thyrotropin Releasing Hormone (TRH) Stimulating test asses pituitaries ability to secrete sufficient amounts of TSH (TSH synthesizes serotonin)
TRH Results 500mg TRH is given IV and then TSH levels are measured at intervals depressed patients have a slow response normal response is within 30 minutes
Dexamethasone Suppresion Test (DST) Many depressed patients have hypersecretion of cortisol (**usefull to measure response to treatment)
Positron Emission Tomography (PET) provids a metabolic profile recealing the rate of tissue consumption of biochemicals (depression = hypometabolism)
Regional Cerebral Blood Flow Mapping (RCBF) Shows regions of blood flow (dark is less active)*suggests that people with depression have a decreased brain metabolic rate
Urinary MHPG useful for deciding medicationlow MHPG- norepinephrine stimulantsintermediate- great choice of drugshigh MHPG- Serotonin stimulants*must stop medication for 1wk prior to test
1st line of treatment for depression SSRIs (effective, safe, fewer side effects)
Second line of defense SNRIs (used for tx resistance and postpartum)
DNRIs well tolerated, typically no sexual dysfunction
TCAs block reuptake of serotonin and norepinephrine-takes 2wks to become effective-many side effects
Prozac SSRIdrowsiness, anxiety, headahce, insomnia, d+do not double dose, no alcohol
Elavil Tricycliclethargy, blurred vision, anticholinergicphotosensitvity, 2wks to take effect
Nardil MAOIdizziness, HA, arrythmias, seizureavoid tyramine
Bupropion DNRIseizure, HAphotsensitivity, take missed dose asap and space 4hrs apart
What do MAOIs do? Breakdown neurotransmitters in the bodyMAO is needed in the body to break down meds which is why there are so many contraindications with MAOIs
Warning for people on MAOIs Do not eat foods with tyramine (promotes production of norepinephrine and can cause a hypertensive crisis)avoid meds containing ephedrine
Thorazine Given to patients on MAOIs incase of a hypertensive crisis from ingesting tyramine
Phentolamine (REGITINE) used IV for MAOI hypertensive crisis
Electroconvulsive Therapy (ECT) Electrically induced seizure to one or both sides of the brain lasting 30-60 seconds(6-12 tx 3/week)
What two medications are give to a patient undergoing an ECT Brevatol-short acting anestheticSuccinylcholine- muscle relaxant(to prevent injury)
Psychotherapy Effective when used along with medication-helps monitor risk of suicide
Niacin Supplements can be used to turn tryptophan into serotonin
Vitamin B6 neccessary to produce serotonin, can be depleted by antidepressants, oral contraceptives, antihypertensives
sleep therapy helps promote REM sleep
Phototherapy used for Seasonal Affective Disorder (SAD)administers light 1-2 hours upon wakening
Baby blues self-limiting usually starts on the 4th or 5th postpartum dayusually last 24-48 hours
Postpartum major mood depression aka postpartum depressiononset between 3-12 months postpartumlast 1yr or longer
Postpartum Neurosis (anxiety, munchheuser syndrome)able to function but feel uncomfortablemanifests as anxiety, phobias, obsessions, hypochondrias
Postpartum psychosis extreme altered perceptions of realityonset 3-4 wks postpartum
Created by: jas067
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