Depression with melancholic features — Flashcards

Flashcard 1: Tricyclic antidepressants (TCAs) may be used for treatment-resistant _____

Answer: depression

Flashcard 2: Neuro/Psych Adverse effects of tricyclic antidepressants (TCAs) include respiratory _____ and hyperpyrexia

Answer: depression

Flashcard 3: Atypical depression is associated with _____, which is being able to experience improved mood in response to positive events, albeit briefly

Answer: mood reactivity

Flashcard 4: Atypical depression is associated with _____-phagia

Answer: hyper

Flashcard 5: In major depressive disorder with seasonal pattern, _____ symptoms are common (ex. hypersomnia, hyperphagia, leaden paralysis)

Answer: atypical

Flashcard 6: What is the first-line treatment for atypical depression? _____

Answer: CBT and SSRIs

Flashcard 7: What are the neurochemical changes typically associated with depression?

Answer: Decreased levels of Norepinephrine (NE), Dopamine, and Serotonin (5-HT).

Extra: Biological basis of depression. Note: Early morning awakening (terminal insomnia) is a classic vegetative symptom of MDD.

Flashcard 8: What is the primary site of serotonin (5-HT) synthesis in the brain?

Answer: Raphe nuclei

Extra: The Raphe nuclei are found in the brainstem (medulla, pons, and midbrain). They project serotonin to nearly all parts of the central nervous system.

Flashcard 9: A woman status post mastectomy says she feels ugly when she undresses.

Answer: Find out why the patient feels that way. Do not offer false reassurance or anything that could be interpreted as flirtation. (e.g. You still look great!)

Flashcard 10: What changes in sleep patterns are often seen in depressed patients?

Answer: 1. less delta-wave sleep 2. more REM sleep 3. more/earlier awakenings (decreased delta-wave sleep (stage N3) decreased REM latency increased REM early in sleep cycle increased total time in REM repeated nighttime awakenings early-morning awakening)