MDD

AFFECTIVE DISORDERS

mental illnesses characterized by pathological changes in MOOD

• Unipolar disorder (depression, mania)

• Bipolar disorder (manic-depressive illness) – “cycling mood”

Two types of affective disorders

MAJOR DEPRESSIVE DISORDER (MDD

Characterized by a DEPRESSED mood most of the time for at least 2 weeks or loss of interest or pleasure in most activities

• Feeling of self guilt or low self esteem

• Disturbed sleep/appetite

• Poor concebtrstion

• Low energy

• Suicidal thoughts

Symptoms of major depressive disorder

Electroconvulsive therapy

Alternative non pharmacologic therapy for depression where shockwaves are trans itted to the brain. One session is effective for 6 months

• 6 weeks

• 6-9 months

• 3-5 years or lifelong

• SSRIs

• TCA

• MAOIs

• SARI

• NDRI

• NaRI

What Are the antidepressants

• Fluoxetine

• Sertraline

• Citalopram

What are the first line drugs for depression

• Amitriptyline

• Amoxapine

• Imipramine

• Desipramine

TCAs

• Phenelzine

• Isocarboxazid

• Tranylcypromine

• Meclobemide

MAOIs

• Trazodone

• Nefazodone

SARIs

Bupropion

NDRIs

Reboxetine

NaRi

Venlafaxine (Effexor

Serotonin and NE reuptake inhibitor (SNRI)

Mirtazapine (Remeron)

noradrenergic and specific serotonergic antidepressant (NaSSA)

Lithium Carbonate (Eskaligh, Quilonium)

• DOC Mania (Antimanic/Mood Stabilizer)

• unknown mechanism

• Narrow therapeutic index

• Therapeutic range: 0.6-1.2 mEq/L

• Valproic acid

• Carbamazepine

What mood stabilizers interact with lithium

False

True or false

• Hypernatremia increases the risk of lithium toxicity