Mental Health Disorders

GAD Definition

Persistent and excessive worry about life for at least 6 months and causing impairment of life

GAD First-Line Treatment

CBT. Also SSRIs, hydroxyzine, buspirone, and benzodiazepines

Insomnia Definition

Difficulty sleeping 3 nights/week for at least 3 months

Insomnia Treatment

CBT-I (sleep hygiene). Also Non-benzodiazepine sedative-hypnotics, melatonin agonists, sedating antidepressants, antihistamines and benzodiazepines

Narcolepsy Definition

Excessive daytime sleepiness

Narcolepsy Symptoms

Excessive daytime sleepiness, cataplexy, sleep paralysis and vivid hallucinations

Narcolepsy Treatment

First-Line Therapy: Modafinil (for wakefulness)

Supporitve therapy

MDD Definition

Persistent low mood and loss of interest or pleasure for at least 2 weeks

MDD Symptoms

Depressed mood, weight changes, insomna/hypersomnia, worthlessness, sucidial ideation. Must persist for 2 weeks

MDD Treatment

SSRIs, SNRIs, TCAs, MAOIs,

Other Treatments: ECT, TMS, Ketamine therapy, or exercise

Serotonin Syndrome Definition

Potentially life threatening condition caused by excessive serotonin activity in CNS. Usually due to DDI or overdose

Serotonin Syndrome Symptoms

Cognitive (mental status change), autonomic (hyperthermia, tachycardia or hypertension), and neuromuscular (muscle rigidity)

Serotonin Syndrome Treatment

Immediate discontinuation of drugs

Supportive care

Serotonin antagonists

Monitoring

Prevention

BPD Definition

Mania or hypomania that alternates with periods of depression

BPD Symptoms

Alternating episodes of depression and mania

BPD Treatment

Mood stabilizers (Lithium, valproic acid)

Antipsychotics

Antidepressants

Psychotherapy

Schizophrenia Definition

Distorted thinking, perception, emotions, and behavior

Schizophrenia Symptoms

At least 6 months and 1 month of positive symptoms (delusions, hallucinations, or disorganized speech/behavior). Negative symptoms are flat affect, avolition, anhedonia and social withdrawal

Schizophrenia Treatment

First-Line: Antipsychotics

Typical: Haloperidol or chlorpormazine

Atypical: Risperidone or aripiprazole

May Also include CBT, social skills training, family therapy and community support programs

Adverse Effects of Antipsychotics

Anticholinergic effects

CV effects (Orthostatic hypertension and QT prolongation)

Hyperprolactinemia

Extrapyramidal Symptoms (EPS)

Parkinsonism, dystonia and Akathisia

Extrapyramidal Treatment (EPS)

Anticholinergics, beta-blockers, or switch to atypical antipsychotics

Tardive Dyskinesia (TD) Definition

Long-term side effect of antipsychotic use causing irreverisble involuntary movement

Tardive Dyskinesia (TD) Symptoms

Lip smacking, tongue thrusting, or chewing movement

TD Treatment

Discontinuation or reduce antipsychotic use

Neuroleptic Malignant Syndrome (NMS) Definition

Rare-life threatening condition caused by antipsychotic conditions (usually first-gen antipsychotics)

NMS Symptoms

Muscle rigidity, autonomic dysregulation (autonomic processes like tachycardiam labile blood pressure, and diaphoresis)

NMS Treatment

Immediate discontinuation, supporitve care (IV fluids and cooling), medication (dantrolene), or ICU for severe cases