Anxiety and Depression

Definitions

100

Screening tool for Depression 

PHQ2

200

Persistent, excessive, uncontrollable and unrealistic worry about everyday things. 

Generalized Anxiety Disorder (GAD)

300

Persistent, mild depressive symptoms for at least 2 years

Dysthymia

400

Mental status changes, neuromuscular hyperactivity and autonomic hyperactivity from over-activation of 5HT-1A and 5HT-2A receptors. 

Serotonin Syndrome

500

A neurological disorder characterized by repetitive,  involuntary movements of the face and jaw

Tardive Dyskinesia

Adverse Effects

100

Constipation, orthostatic hypotension, dry mouth, urinary retention

Anticholinergic side effects of TCA

200

Hypertension is an adverse effect at high doses

SNRI

300

Cognitive impairment

Benzodiazepines

400

Priapism

Trazodone

500

Akathisias 

SSRI, SNRI

Treatment

100

First-line therapy for generalized anxiety disorder

Cognitive Behavioral Therapy

200

Has the highest rates of response and remission of any form of antidepressant treatment

ECT (electroconvulsive therapy)

300

Treatment for sexual dysfunction associated with antidepressants

Bupropion, buspirone, sildenafil

400

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

500

Treatment of myoclonus associated with TCA/MAOI

Clonazepam

Miscellaneous

100

Labs for organic causes of depression (name 3)

CBC, TSH, B12, RPR, HIV, CMP, blood alcohol level, tox screen/UDS, ACTH stimulation test.

200

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

300

Lowers the seizure threshold

Bupropion

400

Increased risk of gastrointestinal bleeding

SSRI

500

dizziness, electric sensory phenomena, or flu like symptoms

Serotonin withdrawal syndrome

Worst with paroxetine and SNRI

Monitoring

100

Patient questionnaire to assess treatment response

PHQ9

 Goal is remission, AKA PHQ9 score < 5

200

Consider baseline bone density prior to starting

SSRI

300

Monitor cholesterol while on this medication

Mirtazapine

400

Baseline EKG, Blood pressure and heart rate

TCAs

Cause SVT/arrhythmia (quinidine effect), hypotension, prolonged QT

500

Hepatic function at baseline and periodically

Nefazodone