Treatment-resistant depression — Flashcards

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

Answer: depression

Flashcard 2: In addition to schizophrenia, _____ antipsychotics are used to treat treatment-resistant depression

Answer: atypical

Flashcard 3: _____ are an effective treatment for atypical depression, but not first-line due to their risk profile

Answer: MAO inhibitors

Flashcard 4: Which atypical antidepressant is useful for treating depressed patients with insomnia? _____

Answer: Mirtazapine

Flashcard 5: Persistent depressive disorder is also known as _____

Answer: dysthymia

Flashcard 6: 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 7: 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 8: 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 9: 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 10: 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