Mental Health: Major Depressive Disorder and its Treatments

Flashcards covering Major Depressive Disorder (MDD) symptoms, diagnostic criteria, and pharmacological treatments including SSRIs, MAOIs, and TCAs.

What components make up the mnemonic "SIG E CAPS" for identifying the signs and symptoms of Major Depressive Disorder (MDD)?

S - Changes in Sleep, I - Lost of Interest, G - Guilt, E - Decreased Energy, C - Decreased Concentration, A - Increase or decrease in Appetite, P - Psychomotor Retardation, S - Suicidal Ideation

What are the specific diagnostic criteria for Major Depressive Disorder (MDD) regarding the duration and quantity of symptoms?

The patient must admit to being depressed or have a loss of interest, plus exhibit at least $5/8$ of the "SIG E CAPS" symptoms within the same $2$ weeks.

What is the recommended treatment sequence for Major Depressive Disorder (MDD)?

Cognitive behavioral therapy (CBT) followed by Pharmacological intervention (Ex. SSRI).

Which medications are listed as examples of Selective Serotonin Reuptake Inhibitors (SSRIs)?

Citalopram, Escitalopram, Sertraline, and Fluoxetine.

What are the documented side effects and monitoring requirements for SSRIs?

Side effects include sexual dysfunction and weight gain; monitoring should include watching for suicidal ideation.

What key education should a patient receive regarding the onset of effectiveness for SSRIs?

It take $4-6$ weeks for SSRIs to become effective.

How should a patient's medication be managed when they are stopping SSRIs?

Do not abruptly stop SSRIs; the patient must be tapered off them.

What life-threatening condition is associated with an excess of serotonin, often caused by mixing SSRIs with St. John’s Wort or other psych meds?

Serotonin Syndrome.

When switching a patient from an SSRI to another medication, what is the required washout period?

$10 to 14$ days to allow the SSRIs to leave their system.

What medication is used as a treatment for Serotonin Syndrome?

Cyproheptadine.

Which medications are categorized as Monoamine Oxidase Inhibitors (MAOIs)?

Selegiline, Phenelzine, and Isocarboxazide.

What dietary restriction must patients on MAOIs follow to avoid a hypertensive crisis?

Do not consume tyramine, found in wine, cheese, processed meats, and chocolate.

What are the symptoms and treatment for a hypertensive crisis related to MAOI use?

Symptoms include HA/N/V/CP, Tachycardia, and SOB; the treatment is Phentalomine.

Which medications are classified as Tricyclic Antidepressants (TCAs)?

Amitriptyline, Nortriptyline, and Imipramine.

Why are Tricyclic Antidepressants (TCAs) avoided in elderly patients and considered severely toxic?

They are severely cardio toxic and can lead to V-Fib.

What are the documented off-label uses for Amitriptyline and Imipramine?

Amitriptyline can be used for fibromyalgia and Imipramine can be used for enuresis (bed wetting) in children.

What are the characteristics of "postpartum blues" regarding prevalence and duration?

Happens in $50\%-80\%$ of moms, involves feeling sad or tearful, and typically resolves in $3-5$ days.

What are the characteristics and treatment for postpartum depression?

Happens to $10\%-15\%$ of moms, lasts about $2$ weeks, follows "SIG E CAPS" symptoms, and is treated with CBT followed by SSRIs.