Definitions
Screening tool for Depression
PHQ2
Constipation, orthostatic hypotension, dry mouth, urinary retention
Anticholinergic side effects of TCA
First-line therapy for generalized anxiety disorder
Cognitive Behavioral Therapy
Labs for organic causes of depression (name 3)
CBC, TSH, B12, RPR, HIV, CMP, blood alcohol level, tox screen/UDS, ACTH stimulation test.
Patient questionnaire to assess treatment response
PHQ9
Goal is remission, AKA PHQ9 score < 5
Persistent, excessive, uncontrollable and unrealistic worry about everyday things.
Generalized Anxiety Disorder (GAD)
Hypertension is an adverse effect at high doses
SNRI
Has the highest rates of response and remission of any form of antidepressant treatment
ECT (electroconvulsive therapy)
Common conditions associated with anxiety (name 3)
Thyroid disease, Migraine, Cancer, Mitral valve prolapse, Chronic pain, Vestibular disorders, Cardiac disease, Allergic condition,s Irritable bowel syndrome, Respiratory disease
Consider baseline bone density prior to starting
SSRI
Persistent, mild depressive symptoms for at least 2 years
Dysthymia
Cognitive impairment
Benzodiazepines
Treatment for sexual dysfunction associated with antidepressants
Bupropion, buspirone, sildenafil
Lowers the seizure threshold
Bupropion
Monitor cholesterol while on this medication
Mirtazapine
Mental status changes, neuromuscular hyperactivity and autonomic hyperactivity from over-activation of 5HT-1A and 5HT-2A receptors.
Serotonin Syndrome
Priapism
Trazodone
Augmentation agents for depression treatment (name 3)
Anxious depression: buspar, gabapentin/lyrica, mirtazapine, hydroxyzine
Depression: L-merthyl-folate, atypical antipsychotics, vortioxetine
Low energy: bupropion, T3
Increased risk of gastrointestinal bleeding
SSRI
Baseline EKG, Blood pressure and heart rate
TCAs
Cause SVT/arrhythmia (quinidine effect), hypotension, prolonged QT
A neurological disorder characterized by repetitive, involuntary movements of the face and jaw
Tardive Dyskinesia
Akathisias
SSRI, SNRI
Treatment of myoclonus associated with TCA/MAOI
Clonazepam
dizziness, electric sensory phenomena, or flu like symptoms
Serotonin withdrawal syndrome
Worst with paroxetine and SNRI
Hepatic function at baseline and periodically
Nefazodone