18 Questions
How does serotonin syndrome often resolve within 24 hours?
By discontinuing the serotonergic agent and initiating care.
What are the five central principles in the management of serotonin syndrome?
Discontinuation of all serotonergic agents, supportive care aimed at normalization of vital signs, sedation with benzodiazepines, administration of serotonin antagonists, assessment of the need to resume use of causative serotonergic agents after resolution of symptoms.
What is the recommended approach for controlling agitation in serotonin syndrome?
Sedation with benzodiazepines
What is the antidote for serotonin syndrome?
Cyproheptadine
Which antidepressants should be avoided in patients with epilepsy or prone to seizures?
TCAs, venlafaxine
What is the role of ice packs in managing serotonin syndrome?
To help with hyperthermia
What is the rationale behind using pharmacotherapy for depression?
- Relieve psychological and physical symptoms, 2. Improve functional capacity, 3. Reduce the likelihood of self-harm or suicide
When should drug treatment be started for depression?
Drug treatment should be started when the depression is moderate to severe, and the diagnostic criteria have been fulfilled for more than 2 weeks.
What is recommended in addition to drug treatment for depression?
Psychotherapy, especially cognitive behavioral therapy (CBT), is recommended in addition to drug treatment.
In what cases should a psychiatrist manage depression?
Severe depression, such as with serious suicidal behavior or psychotic features, warrants management by a psychiatrist, often in a hospital setting.
What factors influence the choice of antidepressant medication?
- Previous response to antidepressants, 2. Concurrent medical and psychiatric illnesses, 3. Adverse effects of the drug, 4. Potential for drug interactions
How effective is psychotherapy alone for treating depression?
Psychotherapy alone may be effective in treating mild to moderate cases of depression.
What are the main symptoms of severe major depression?
The main symptoms of severe major depression include considerable distress, agitation or psychomotor retardation, inability to continue usual activities beyond a minimal extent, prominent somatic symptoms, and high risk of suicide.
What is the primary aim of treatment for severe major depression?
The primary aim of treatment for severe major depression is to prevent harm and relieve distress, or to be prophylactic.
What are the two main types of psychotherapy mentioned for treating severe major depression?
The two main types of psychotherapy mentioned are psychodynamic psychotherapy and cognitive therapy.
How common is severe major depression in primary care or community (outpatient) practice?
Severe major depression is uncommon (less than 5% of those presenting with depression) in primary care or community (outpatient) practice.
What is the role of pharmacological intervention in the treatment of moderate to severe depression?
For moderate to severe depression, pharmacological intervention is important, in addition to considering social, cultural and environmental influences on the patient.
What is the main goal of cognitive therapy in treating depression?
Cognitive therapy assumes that a patient's symptoms like anxiety and depression arise from misperceptions and dysfunctional thoughts and beliefs, and it teaches patients to identify and respond to these thoughts and beliefs to change their thinking, mood, and behavior.
Learn about the symptoms of severe major depression, including distress, agitation, and psychomotor retardation. Understand the risks associated with somatic symptoms and the heightened risk of suicide. Explore how uncommon severe major depression is in primary care or outpatient settings.
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