-
Neurotransmitters, 5-HT, DA and NE, are increased or decreased in depression?
Decreased
-
What are the theories of depression?
- biogenic amine hypothesis
- 5-HT/NE link hypothesis
- postsynaptic alteration theory
- disruption of Brain Derived Neuropathic Factor expression in the hippocampus
-
Approximately 45% to 60% of patients with major depression have what biological marker:
- Neuroendocrine abnormality
- Including: hypersecretion of cortisol or a lack of cortisol suppression
- Inability of the brain to suppress the hypothalamic–pituitary–adrenal (HPA) axis
-
All depressed patients should have what diagnostics performed?
- Complete physical examination
- Mental status examination
- Basic laboratory workup, with CBC w/ differential, thyroid function tests, and electrolytes
-
What drugs are associated with Depression?
- Acne treatment: Isotretinoin
- Anticonvulsants: Levetiracetam, Topiramate, Vigabatrin, Antimigraine agents, Triptans
- Cardiovascular medications:β-Blocker, Clonidine, Methyldopa, Reserpine
- Hormonal therapy: Gonadotropin-releasing hormone, Oral contraceptives, Steroids (e.g., prednisone), Tamoxifen
- Immunologic agents: Interferons, Smoking cessation drugs, Varenicline
-
What are the major physical symptoms of depression?
- Fatigue
- Pain (like HA)
- Sleep and appetite disturbances
- Loss of Libido
- Slowed movements
-
What are the mnemonics for the diagnosis of depression?
- SIGECAPS: Sleep, Interest, Guilt, Energy loss, concentration, appetite, psychomotor agitation, suicidal thoughts
- SAD FACES: Sleep, appetite, depressed, fatigue, agitation, concentration, esteem, suicidal thoughts
-
Should anti-depressives be withheld in children/Adolescents with suicidal ideation?
No, withholding may increase the risk
-
What anti-depressives provide protection against suicide in adults and elderly?
Fluoxetine and Venlafaxine
-
What anti-depressives were found to not increase suicidality in young people?
Fluoxetine and Venlafaxine
-
If the depressive episode is mild to moderate in severity, what is the first line agent?
Psychotherapy
-
What are the advantages of SSRIs?
- Increased safety in overdose
- Improved tolerability
|
|
