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| what is the most widely accepted reference for care of mentally ill pts? |
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| diagnostic and statistical manual of Mental Disorders- 5th ed. (DSM-5) |
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| a mental status exam invovles a direct _ along with lab work and pt history |
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| what is included in a neuropsych eval? -5 |
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sensorium
attention
intelligence
memory
orientation |
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intiital therapy fr depression-4
what do you do then? |
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SSRI, SNRI, burporpion, mirtzapine
titrate to therapeutic dose and check in 4-6 wks |
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if after intial therapy for depression get partial response what do you do?
1)
2) _
and/or |
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increase dose if not at max
add psychotherapy
add augemntation agent |
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| psychotherapy cna be used over drugs for depression when? |
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| if pt is not moderte to severe depression |
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| what are some augmentation devices for depression that have good evidence of efficacy -4 |
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non MAOI
lithium
thyoird hormone
2nd gen antipsychotic |
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| what are some augemntaiton devices that have less supporting evidence-4 |
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folic acid
omega 3
anticonvulsant
stimulants |
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if pt had no repsonse to the intial antidepressant therapy what do you do?
can you choose a diff one within the same class? |
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disct med and try another non MAOI
yes! or another class |
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| what is reserved for last treatment option of depression? |
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fluoxetine
paroxetine
sertraline
fluvoxamine
citalopram
escitalopram |
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venalfaxine
duloxetine
levomeilnacipram |
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| what are decreased postivie effects of depression -3 |
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anhedonia
decreeased energy
apathy |
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| what antidepressants would be good for increasing postive affects |
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| drugs that increase Ne or DA |
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what are the increased negative affects of depression? -2
what med would be best for this? |
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anxiety
suicide
-ones that increase serotonin |
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| these increase serotonin by inhitng its metabolism-5 |
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pehnelzine
trancycloprime
selegiline
linezolid
st johns wort |
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| these increase serotonin by increase release-5 |
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LSD
ectasy
cocaine
dextromethorphan
meperidine |
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| these increase serotonin by activaitng receptor |
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| these increase serotonin by inhibitng reuptake-7 |
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dextromethorphan
meperidine
tramadol
duloxetine
venalfaxine
TCAs
SSRIs |
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