Podcast
Questions and Answers
Which tricyclic antidepressant (TCA) is considered the most effective for treating Obsessive-Compulsive Disorder (OCD)?
Which tricyclic antidepressant (TCA) is considered the most effective for treating Obsessive-Compulsive Disorder (OCD)?
What is a common adverse anticholinergic effect associated with tricyclic antidepressants (TCAs) that might require management with sugarless gum or fluoride lozenges?
What is a common adverse anticholinergic effect associated with tricyclic antidepressants (TCAs) that might require management with sugarless gum or fluoride lozenges?
Which condition is a contraindication for the use of tricyclic antidepressants (TCAs) due to potential cardiac effects?
Which condition is a contraindication for the use of tricyclic antidepressants (TCAs) due to potential cardiac effects?
For a patient experiencing urinary hesitancy as a side effect of tricyclic antidepressant (TCA) treatment, which medication might be considered for management?
For a patient experiencing urinary hesitancy as a side effect of tricyclic antidepressant (TCA) treatment, which medication might be considered for management?
Signup and view all the answers
Which of the following is NOT a typical ECG change associated with tricyclic antidepressant (TCA) use?
Which of the following is NOT a typical ECG change associated with tricyclic antidepressant (TCA) use?
Signup and view all the answers
What is a significant risk when using tricyclic antidepressants (TCAs) for individuals with bipolar depression?
What is a significant risk when using tricyclic antidepressants (TCAs) for individuals with bipolar depression?
Signup and view all the answers
What is the most common autonomic adverse effect associated with tricyclic antidepressants (TCAs) that can lead to falls or injuries?
What is the most common autonomic adverse effect associated with tricyclic antidepressants (TCAs) that can lead to falls or injuries?
Signup and view all the answers
Besides SSRIs, what is another class of medications that TCAs could be considered as an alternative to?
Besides SSRIs, what is another class of medications that TCAs could be considered as an alternative to?
Signup and view all the answers
Which tricyclic antidepressant (TCA) is associated with the lowest risk of causing orthostatic hypotension?
Which tricyclic antidepressant (TCA) is associated with the lowest risk of causing orthostatic hypotension?
Signup and view all the answers
Why should tricyclic antidepressants (TCAs) be stopped several days prior to elective surgery?
Why should tricyclic antidepressants (TCAs) be stopped several days prior to elective surgery?
Signup and view all the answers
Which of the following is a common side effect of tricyclic antidepressant (TCA) use due to its anticholinergic and antihistaminergic properties?
Which of the following is a common side effect of tricyclic antidepressant (TCA) use due to its anticholinergic and antihistaminergic properties?
Signup and view all the answers
Which tricyclic antidepressant (TCA) is most likely to cause parkinsonian symptoms, akathisia, and dyskinesia?
Which tricyclic antidepressant (TCA) is most likely to cause parkinsonian symptoms, akathisia, and dyskinesia?
Signup and view all the answers
What specific risk is associated with maprotiline, regarding the dosage and use?
What specific risk is associated with maprotiline, regarding the dosage and use?
Signup and view all the answers
Which of the following is a rare but serious hepatic effect associated with tricyclic antidepressants (TCAs)?
Which of the following is a rare but serious hepatic effect associated with tricyclic antidepressants (TCAs)?
Signup and view all the answers
What are the primary symptoms of neonatal withdrawal syndrome caused by tricyclic antidepressant (TCA) exposure during pregnancy?
What are the primary symptoms of neonatal withdrawal syndrome caused by tricyclic antidepressant (TCA) exposure during pregnancy?
Signup and view all the answers
Which of these is NOT a common neurologic effect of tricyclic antidepressants (TCAs)?
Which of these is NOT a common neurologic effect of tricyclic antidepressants (TCAs)?
Signup and view all the answers
Which of the following is a common symptom of serotonin syndrome?
Which of the following is a common symptom of serotonin syndrome?
Signup and view all the answers
Which of the following SSRIs is LEAST likely to be associated with withdrawal symptoms?
Which of the following SSRIs is LEAST likely to be associated with withdrawal symptoms?
Signup and view all the answers
Which of the following SSRIs is metabolized by the CYP3A4 enzyme and should not be administered with alprazolam, triazolam and diazepam?
Which of the following SSRIs is metabolized by the CYP3A4 enzyme and should not be administered with alprazolam, triazolam and diazepam?
Signup and view all the answers
Which of the following is a common side effect associated with venlafaxine?
Which of the following is a common side effect associated with venlafaxine?
Signup and view all the answers
Which of the following statements is correct about the use of bupropion?
Which of the following statements is correct about the use of bupropion?
Signup and view all the answers
Which of the following best describes how mirtazapine increases norepinephrine and serotonin?
Which of the following best describes how mirtazapine increases norepinephrine and serotonin?
Signup and view all the answers
What is a primary therapeutic indication for duloxetine besides depression?
What is a primary therapeutic indication for duloxetine besides depression?
Signup and view all the answers
What is a significant precaution associated with the use of duloxetine?
What is a significant precaution associated with the use of duloxetine?
Signup and view all the answers
Which of the following is NOT a common adverse reaction associated with milnacipran or levomilnacipran?
Which of the following is NOT a common adverse reaction associated with milnacipran or levomilnacipran?
Signup and view all the answers
Which statement is true about how fluoxetine is metabolized?
Which statement is true about how fluoxetine is metabolized?
Signup and view all the answers
Which SSRI is most likely to produce a discontinuation syndrome?
Which SSRI is most likely to produce a discontinuation syndrome?
Signup and view all the answers
What is a clinical consideration when dosing vilazodone?
What is a clinical consideration when dosing vilazodone?
Signup and view all the answers
Which of the following is NOT an indication for use of venlafaxine?
Which of the following is NOT an indication for use of venlafaxine?
Signup and view all the answers
What is a key characteristic of nefazodone's half-life?
What is a key characteristic of nefazodone's half-life?
Signup and view all the answers
Which medication is FDA-approved for fibromyalgia but not for depression?
Which medication is FDA-approved for fibromyalgia but not for depression?
Signup and view all the answers
Study Notes
Chapter 7: Depression
- Key symptoms of depression include: depressed mood and loss of interest or pleasure.
- Depression can be a physical illness, characterized by exhaustion and lack of motivation.
- A classic presentation of a depressed patient includes stooped posture, decreased movement, and a downward gaze.
- Observable signs of depression often include generalized psychomotor retardation.
- Neurovegetative symptoms of depression include somatic or physical symptoms.
Table 7-1: Neurovegetative Symptoms of Depression
- Common symptoms include fatigue/low energy and inattention.
- Sleep disturbances, such as insomnia and early morning awakenings, are also common.
- Poor appetite and weight loss can occur.
- Other symptoms such as decreased libido, sexual performance issues, and menstrual irregularities are also possibly associated.
- Symptoms are often worse in the morning
Most Common Complaint: Reduced Energy
- Increased Appetite
- Weight Gain
- Sleeping longer than usual
- Young age of onset
- Higher likelihood of comorbid disorders (e.g., anxiety, substance use disorders, or somatic symptom disorders).
- Atypical (reversed neurovegetative symptoms)
Dysphoria and Anhedonia
- Dysphoria is a term for depressed mood.
- Anhedonia refers to the inability to experience pleasure from activities formerly enjoyable.
Other Key Symptoms
- Cognitive symptoms: reports of difficulty concentrating and thinking problems.
- Judgement assessment: done by reviewing recent patient actions and behaviors during the interview.
Additional Information on Major Depressive Disorder (Diagnositc Information)
- 5 or more symptoms must be present for at least two weeks.
- Symptoms include anhedonia, depressed mood and other SIGECAPS factors such as: sleep (difficulty), interest (loss), guilt, energy (loss), concentration (difficulty), appetite (loss), psychomotor retardation (slow movement), suicide ideation
- Altered sleep: difficulty sleeping and early morning awakening
- Altered activity or energy
- Decreased concentration
- SI/plan
- Depressing thoughts
- With psychotic features: congruent mood
- With melancholic features: aka endogenous depression, associated with autonomic and endocrine changes, without external life supports.
- With atypical features: reversal of typical neurovegetative symptoms (increased appetite, sleep, and younger age of onset) and a higher incidence of severe psychomotor slowing.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on tricyclic antidepressants (TCAs) and their effects on mental health disorders, particularly Obsessive-Compulsive Disorder (OCD). This quiz covers common side effects, contraindications, and management strategies for patients using TCAs. Challenge yourself to identify important considerations in TCA treatment.
