Understanding Major Depressive Disorder

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which condition is NOT associated with the use of John’s wort?

Neuroleptic malignant syndrome (NMS) (correct)

Increased suicidal ideation

Generalized anxiety disorder (GAD)

Serotonin syndrome

What is a common physical symptom of serotonin syndrome?

Clonus (correct)

Somnolence

Bradycardia

Weight loss

Which drug is known to potentially induce serotonin syndrome?

Gabapentin

Bupropion

Metoclopramide (correct)

Lamotrigine

What does PMR stand for in treatment terms?

Progressive muscle relaxation Signup and view all the answers

Which of the following is a potential outcome of serotonin syndrome?

Autonomic instability Signup and view all the answers

Lavender oil is primarily discussed for its application in treating which condition?

Generalized anxiety disorder (GAD) Signup and view all the answers

What age group has an increased risk of suicidal ideation when taking certain medications?

13-24 years old Signup and view all the answers

Which of the following is NOT considered a serotonergic drug?

Ibuprofen Signup and view all the answers

What is a primary indication for Sodium Valproate?

Focal and generalized tonic-clonic seizures Signup and view all the answers

Which disorder is characterized by excessive fear or anxiety of social situations?

Social Anxiety disorder Signup and view all the answers

What differentiates obsessive-compulsive disorder from general anxiety?

Presence of obsessions and/or compulsions Signup and view all the answers

Which of the following symptoms would not be associated with PTSD?

Compulsions to perform rituals Signup and view all the answers

What is a potential second-line treatment option for absence seizures?

A2delta ligands Signup and view all the answers

Which disorder involves persistent thoughts that cause marked anxiety or distress?

Obsessive-compulsive disorder Signup and view all the answers

Which of the following is an indication for Valproic Acid?

Acute treatment of manic phases in bipolar disorder Signup and view all the answers

Which behavioral issue pertains to developmental periods that are considered inappropriate for the symptom's persistence?

Social Anxiety disorder Signup and view all the answers

What effect does prolonged exposure to Enflurane primarily liberate?

F- ions Signup and view all the answers

Which receptor subunit is primarily targeted by sedative agents?

α1 subunit of GABAA Signup and view all the answers

What condition is associated with N2O due to prolonged exposure?

Megaloblastic anemia Signup and view all the answers

What is a known effect of volatile anesthetics on cerebral metabolic rate?

Decrease in CMR and increase in CBF Signup and view all the answers

Which volatile anesthetic is notably linked to hepatitis due to its reactive metabolites?

Halothane Signup and view all the answers

What effect can GABA receptor agonists have on muscle contraction?

Smooth muscle relaxation Signup and view all the answers

What causes respiratory depression during anesthetic administration?

CNS depressant effects Signup and view all the answers

Which anesthetic can disrupt hippocampal theta rhythm?

Halothane Signup and view all the answers

What is the primary reason for using analgesic agents during anesthesia?

To avoid peripheral pain conduction Signup and view all the answers

How does volatile anesthetics affect myocardial function?

Causes myocardial depression Signup and view all the answers

What is a characteristic side effect of medications like Duloxetine?

Uncontrolled angle-closure glaucoma Signup and view all the answers

Which drug has a noted effect of dose-dependent inhibition of norepinephrine transporter (NET)?

Venlafaxine Signup and view all the answers

Which antidepressant is primarily indicated for Major Depressive Disorder (MDD)?

Vortioxetine Signup and view all the answers

What type of activity is notable for Duloxetine among the listed options?

High CYP inhibition activity Signup and view all the answers

Which of the following medications is NOT typically associated with treating depression?

Vortioxetine Signup and view all the answers

Which medication combination can lead to decreased TCA serum concentrations?

John’s wort and Linezolid Signup and view all the answers

What is a common false-positive result associated with Clomipramine?

Methadone Signup and view all the answers

What is the half-life of Amitriptyline in females?

37 hours Signup and view all the answers

In Bipolar I disorder, what must be present for a diagnosis?

At least one manic episode Signup and view all the answers

Which of the following drugs is a common adjunct used in combination with mood stabilizers for Bipolar Disorder?

Olanzapine Signup and view all the answers

What is one of the primary psychological factors thought to contribute to manic episodes?

Amenable to psychotherapy Signup and view all the answers

What is indicated as a crucial management aspect for patients with Bipolar Disorder?

Combination of 4 mood stabilizers plus antipsychotics Signup and view all the answers

What is a possible result of taking sympathomimetics alongside TCAs?

Increased sympathomimetic activity Signup and view all the answers

What distinguishes Bipolar II disorder from Bipolar I disorder?

Presence of hypomanic episodes Signup and view all the answers

Which of the following describes a symptom of mania?

Increased energy and activity Signup and view all the answers

What is a common misconception about Major Depressive Disorder?

It is identical to Bipolar Disorder. Signup and view all the answers

Which drug is mentioned specifically as having potential false positive results for LSD?

Amitriptyline Signup and view all the answers

What is considered 'not' an etiological factor in Bipolar Disorder?

Weather patterns Signup and view all the answers

What condition is associated with hyperkalemia in this context?

Renal failure Signup and view all the answers

Which side effect is considered a risk of long-term ketamine use?

Addiction and withdrawal symptoms Signup and view all the answers

What effect does ketamine have on the cardiovascular system initially?

Myocardial depression Signup and view all the answers

What psychological effect can ketamine induce that may be distressing to the patient?

Feelings of confusion and euphoria Signup and view all the answers

What is a significant metabolic side effect of propofol infusion?

Propofol Infusion Syndrome (PRIS) Signup and view all the answers

What condition is indicated by 'Ketamine bladder'?

Nocturia and bladder ulcers Signup and view all the answers

What additional medication may be administered before ketamine to reduce pain at the injection site?

Lidocaine Signup and view all the answers

What potential complication is associated with the low pH of propylene glycol used in some anesthetics?

Injection site pain and phlebitis Signup and view all the answers

What hemodynamic effect is associated with a2b receptor agonism?

Cardiovascular stability Signup and view all the answers

Which phrase best describes ketamine's overall effect on sedation?

Causes non-REM sleep with analgesia Signup and view all the answers

Study Notes

Depression

Depression is not an emotion but a medical condition.
It can affect individuals and others.
Major depressive disorder can lead to suicide.
It is experienced for at least two weeks.
It's a leading cause of disability worldwide.
Symptoms include: decreased interest, guilt, decreased energy, trouble concentrating, changes in appetite, psychomotor retardation (sluggishness), suicidality.
SIGECAPS is a mnemonic for remembering symptoms (sadness, emptiness, hopelessness, anhedonia, insomnia/oversleeping, loss of interest, guilt, fatigue, significant weight loss/gain, trouble thinking/concentrating/ indecisiveness, psychomotor agitation/retardation, suicidal ideation).

Major Depressive Disorder

Experienced for at least two weeks.
Key symptoms: depressed mood (sadness, emptiness, or hopelessness), anhedonia (inability to feel pleasure), sleep disturbances (insomnia or oversleeping), loss of interest or pleasure, feelings of guilt, fatigue, weight loss/gain, difficulty concentrating or making decisions, psychomotor agitation or retardation, suicidal ideation.

Eating Disorders

Binge-eating disorder:
- Characterized by episodes of eating large quantities of food quickly, followed by feelings of guilt and shame even without hunger. This may lead to gaining weight.
- Management of the eating disorder is done through psychotherapy.
Avoidant/Restrictive Food Intake Disorder (ARFID):
- Characterized by substantial and significant picky eating and weight loss, without concerns about body shape.
- Vit, nutrient deficiencies and growth slowing are common.
- Management is done through psychotherapy.
Anorexia nervosa (subtypes: restricting, binge-eating/purging):
- Eating restrictions, obsessions with food, and compulsive behaviors related to food.
- Body image distortions and fear of weight gain.
- Management includes psychotherapy. Medications, like Olanzapine, may be considered in some cases.
Bulimia nervosa:
- Binging and compensation (purging, laxatives, or inducing vomiting).
- Concerns around weight gain.
- Management includes Psychotherapy. SSRI or SNRI medications are sometimes considered as an adjunct.

Antidepressants

Etiology is not a chemical imbalance or neurotransmitter deficiency; rather, it includes biological(receptors examined, brain neurotrophic factors (BDNF), gene repression under stress), psychological (learned helplessness, negative cognitive style) and sociocultural (social support, sex/gender, culture) factors.
Selective serotonin reuptake inhibitors (SSRIs) block the serotonin transporter, increasing serotonin levels. This can lead to improvements in passive coping.
Initial binding often leads to side effects that can result in delayed improvements in mood. Tolerance often develops to these side effects, along with delayed increase in Brain-Derived Neurotrophic Factor (BDNF) expression. Ultimately, BDNF binds to TrkB, activating Akt/protein kinase B—activating mTOR/mechanistic target of rapamycin and increasing connections between neurons and removing negative affective biases.
Side effects may include GI issues (nausea/vomiting, diarrhea, constipation), CNS issues (insomnia/sedation, agitation, tremors, dizziness), and others (sexual dysfunction, sweating, weight gain/loss)
The response time for depression is 1-2 weeks, while for anxiety-related and OCD-related disorders it can take 4-12 weeks. The typical duration for reducing relapse risk is 6-9 months for depression and 12 months for anxiety, OCD, PTSD.

Mood Stabilizers

Bipolar disorder is a mental health condition characterized by dramatic shifts in mood, energy levels, and activity levels. It involves two distinct phases: manic and depressive.
Several medications can help with Bipolar disorder. Some drugs are effective in managing the manic phase, others the depressive phase, and some can treat both phases.
Lithium has shown some of the highest efficacy in the treatment of both manic and depressive episodes of bipolar disorder.
It may also be effective in reducing suicidal attempts

Anesthetics

General Anesthetics are used to induce a complete loss of consciousness, amnesia, and pain perception, necessary for various surgical and medical procedures.
Inhalational Anesthetics are inhaled gases or volatile liquids vaporized for administration. These include Sevoflurane, Desflurane, Halothane, Isoflurane, and Nitrous Oxide (N2O).
Intravenous Anesthetics are injected directly into a vein, including Propofol, Ketamine, Etomidate, and Barbituates (Thiopental).
Regional Anesthetics are used for specific areas such as limb blocks, epidural or spinal anesthetics, peripheral nerve blocks, infiltration or topical anesthetics, to block nerve impulses while maintaining consciousness in the patient. These include (but not limited to) Lidocaine, Bupivacaine, Ropivacaine, Mepivacaine, Tetracaine, and Benzocaine.

Other Medications

Anticonvulsants are crucial in the treatment of uncontrolled seizures by modulating neuronal activity and reducing excitatory neurotransmission.
Sedatives and Hypnotics are essential for inducing sleep. These medications primarily target GABAA receptors and include Benzodiazepines (e.g., diazepam, lorazepam, temazepam, alprazolam), Barbiturates (e.g., phenobarbital), and others like Zolpidem and Ramelteon.
Antidepressants are essential for alleviating mood disorders marked by sadness, loss of interest in activities, and feelings of worthlessness, used to treat Major Depressive Disorders (MDD), generalized anxiety disorder (GAD), and related problems. They include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors).
Drugs for Dementia are particularly important for managing cognitive impairment, used largely in the treatment and management of patients experiencing the earlier to moderate stages of Alzheimer's Disease. They work by increasing acetylcholine levels in the brain, a neurotransmitter essential for cognitive function. Drugs include Donepezil, Rivastigmine, Galantamine, and Memantine.
ADHD medications are primarily stimulants that increase levels of dopamine & norepinephrine, particularly helpful in controlling attention deficits, hyperactivity, and impulsivity in patients experiencing ADHD. These include methylphenidate & atomoxetine.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores the clinically significant aspects of Major Depressive Disorder (MDD). Delve into its definition, symptoms, and impact on individuals and society. Understand the role of mnemonics like SIGECAPS in recognizing depressive symptoms and the importance of addressing this leading cause of disability.