Exit exam mental health

for diagnosis, anxiety must be present for ____

6 months

first line treatment for anxiety

ssris and snris

anxiety med that impacts dopamine and serotonin levels. not a controlled substance

buspirone

buspirone starts working w/in ______

2 weeks

if on buspirone, avoid:

grapefruit juice and maois (serotonin syndrome)

for a diagnosis, symptoms of depression must be present for ______

2 weeks

examples of ssris

paroxetine, lexapro, zoloft

time frame to see ssri effects

4-6 weeks

common se of ssris

short term: nausea, diarrhea, ha, insomnia - tend to get better after a few weeks

decreased sexual function/libido and weight gain

which ssris are good for older adults

lexapro (gad and mdd) and zoloft (mdd)

which ssri comes with risk of sedation and weight gain

paroxetine (paxil)- dont use in older adults

ssri good for vasomotor symptoms during menopause

paroxetine (paxil)

what is fluoxetine (prozac) used for

mdd - nervousness is a side effect, dont use for anxiety!

snri examples

cymbalta and effexor

avoid snris in ___

uncontrolled htn

what is bupropion (wellbutrin) used for

mdd, seasonal affective disorder, somking cessation. adhd off label

bupropion (wellbutrin) avoid in ______

anxiety or insomnia (side effect of increased stimulation). seizures

tricyclic antidepressants (amitryptiline) side effects

weight gain, slow down cardiac conduction (over 40 get ekg before starting). anticholinergic effects (avoid in older adults). high potential of death from overdose

what to avoid with maois

avoid prescribing with other antidepressants. 2 week watch out period, can cause serotonin syndrome. avoid foods that contain tyramine as this can lead to hypertensive crisis: aged cheese, fermented sausage, cured meats, alcohol, chocolate, certain nuts

short term vs chronic insomnia

short term: less than 3 months. chronic: at least 3 nights a week for 3 months