Mood Disorders

If a patient has current symptoms of a major depressive episode but history of a manic episode, what is that consistent with?

Bipolar I disorder

Unless a patient is at active risk of harm to self or others,

physicians cannot disclose information to family members without the patient's consent

Multiple sclerosis is frequently associated with 

depression

If someone says "I've had thoughts of taking all of my medications at once", what is that?

It indicates potential suicidal ideation, requiring immediate evaluation.

Hypertensive crisis is the main symptom of

MAO inhibitors with tyramine

Headache, nausea, insomnia/sedation, anxiety, dizziness are early onset side effects for 

SSRIs

This patient's sudden onset of flulike symptoms (fatigue, myalgias, chills, headache, rhinorrhea), insomnia, and tremor following abrupt discontinuation of paroxetine is suggestive of 

antidepressant discontinuation syndrome

The slightly increased risk of antidepressant-related suicidal thoughts and behaviors in some children and adolescents must be weighed against 

the efficacy of antidepressants and the risk of completed suicide in depression

Nonresponders to an adequate trial of a selective serotonin reuptake inhibitor (SSRI) should be switched to

another antidepressant.

ECT is a first-line treatment for

major depression with psychotic features

Bupropion is an antidepressant with mild stimulant properties that can be particularly helpful for

depressed patients

To decrease the risk of depressive relapse, multiple evidence-based treatment guidelines recommend continuing antidepressant treatment for an additional

6 months

Intermittent explosive disorder is characterized by recurrent episodes of

impulsive verbal or physical aggression.

Depression is a common complication of 

Parkinson disease (PD) and multiple sclerosis

Lithium therapy should be maintained in patients whose condition is

stable and who are tolerating the medication.

Bipolar depression requires medication management with second-generation antipsychotics like

lurasidone and quetiapine

Certain medications (eg, lithium) can enhance a

physiologic tremor, which is typically a fine, symmetric action tremor of the hands that increases with sympathetic activity

Physicians should continue antidepressants for at least 

4-6 weeks before considering the next step in treatment.

All antidepressants are associated with a risk for

hypomania/mania in susceptible patients. If this happens, discontinue the antidepressant 

Major depressive disorder is associated with hyperactivity of the

hypothalamic-pituitary-adrenal axis, resulting in increased cortisol levels

Pediatric major depression may present with 

irritability rather than depressed mood

ECT is particularly appropriate for 

severely depressed patients who refuse to eat and drink or are acutely suicidal.

The labile mood states seen in borderline personality disorder tend to fluctuate more 

rapidly compared to bipolar

Treatment options for postpartum depression include 

psychotherapy and/or pharmacotherapy

New-onset psychosis in an adolescent with neurologic dysfunction (eg, tremor, parkinsonism) raises concern for 

Wilson disease

Depression due to medical condition is diagnosed when the medical condition is

directly causing the depression; for example, depression, weight loss, and new-onset diabetes mellitus may be early manifestations of pancreatic cancer.

The addition of nonsteroidal anti-inflammatory drugs (or thiazide diuretics, ACE inhibitors, tetracyclines, and metronidazole) to lithium can increase serum lithium levels and lead to symptoms of toxicity, including

gastrointestinal symptoms, confusion, ataxia, and tremor.

If someone is having depression and has delusions of persecution like his family not wanting him around, the delusions are

mood congruent

Cyclothymic disorder is a chronic mood disturbance characterized by

≥2 years of numerous periods of hypomanic and depressive symptoms

Neuropsychiatric manifestations of Cushing syndrome include 

depressed or labile mood, anxiety, irritability, insomnia, memory deficits, and fatigue