Pharmacotherapy for depression — Flashcards

Flashcard 1: SSRIs inhibit the pre-synaptic reuptake of _____

Answer: serotonin (5-HT)

Flashcard 2: _____ are an effective treatment for atypical depression, but not first-line due to their risk profile

Answer: MAO inhibitors

Flashcard 3: What is the first line treatment for major depressive disorder? _____

Answer: CBT + SSRIs

Flashcard 4: Which atypical antidepressant is useful for treating anorexic or elderly depressed patients? _____

Answer: Mirtazapine

Flashcard 5: 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 6: 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 7: 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 8: 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)

Flashcard 9: Major depressive disorder with seasonal pattern is most associated with what season? _____

Answer: Winter

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 10: Huntington disease presents with chorea that can progress to _____ and dementia; also may have aggression

Answer: depression

Extra:   Watch Creutzfeldt Jakob Disease, Parkinsons Disease & Huntingtons Disease [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-neuro/videos/medical-pathophysiology-neuro-neurodegenerative-creutzfeldt-jakob-disease-parkinsons-disease-and-huntingtons-disease?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/neurology/videos/dementia?index=8] https://onlinemeded.org/spa/genetics?ref=anki Atlas: