Meds
Which are common Antidepressants prescribed for PPD? (select all that apply)
a. Bupropion (Wellbutrin)
b. Escitalopram (Lexapro)
c. Gabapentin (Antiseizure)
d. Sertraline (Zoloft)
e. Propranolol (Antianginal Agent)
Answer: a, b, and d
a. Bupropion (Wellbutrin)
b. Escitalopram (Lexapro)
d. Sertraline (Zoloft)
What are the most common s/s of PPD? (Select all that apply)
Inability to concentrate
Irritability
Low self-esteem
Mood swings
Persistent sadness
No interest in bonding with baby
sleep/appetite disturbances
Answer: ALL ARE CORRECT
What are the key symptoms used to diagnose depression?
a. Happiness for over 3 weeks
b. Lots of energy for 1 week
c. Concentrating excellent in class
d. Persistent sadness for over 2 weeks
Answer: d
Rationale: Depression is diagnosed based on symptoms such as persistent sadness, loss of interest or pleasure in activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide. A person must experience 5 or more symptoms for at least 2 weeks for a diagnosis.
True or False:
The pathophysiology of postpartum depression is complex, and not yet fully ascertained. However, there is evidence that biological factors, including hormonal factors, genetics, and immune function, may play a role.
Answer: True
Rational: there is evidence that biological factors, such as hormonal factors, genetics, and immune function, may play a role.
T or F: Antidepressants can be used as monotherapy, combined with psychotherapy, or combined with supplemental interventions.
Answer: True
What is the main cause of PPD?
a. Happy fulfilled, loving, supportive, marriage/partner
b. Not having a baby
c. Hormonal imbalances (Estrogen, Progesterone, Prolactin, Thyroxine)
d. Normal sleep schedule
Answer: c. Hormonal imbalances (Estrogen, Progesterone, Prolactin, Thyroxine)
What are the main treatment options for depression?
a. Acupuncture
b. Spending time with your dog
c. Having surgery
d. SSRIs and lifestyle changes
Answer: D
Rationale: Treatment typically includes a combination of psychotherapy (e.g., cognitive-behavioral therapy), medications (like SSRIs or SNRIs), and sometimes lifestyle changes. In severe cases, electroconvulsive therapy (ECT) may be considered.
Which of the following problems are considered possible to co-occur with postpartum depression? (select all that apply)
a. anxiety
b. obsessive-compulsive disorder
c. Trauma related disorders
d. none
Answer: a, b, and c
Rational: problems such as anxiety, obsessive-compulsive disorder, and trauma are related disorders to co-occur with postpartum depression.
T or F: Treatment for postpartum depression with antidepressants while the mother is breastfeeding is not an option of treatment because of the exposure of the medication to the infant.
Answer: False
Rationale: Although some patients who are breastfeeding may express concerns about using antidepressants and infant exposure, they can be reassured that relatively low amounts are excreted into breast milk and that antidepressants are generally regarded as safe for the infant.
Identify 4 risk factors associated with PPD?
a. Stressful life events
b. Supportive partner
c. Anxiety/depression during pregnancy
d. Available childcare support
e. Poor social support
f. Childcare difficulties
Answer: a, c, e, f
a. Stressful life events
c. anxiety/depression during pregnancy
e. Poor social support
f. Childcare difficulties
How long does it usually take for antidepressant medications to start working?
a. Immediately
b. 1 week
c. 2 to 4 weeks
d. 3 to 4 months
Answer: C
Rationale: Antidepressants typically take 2 to 4 weeks to start showing effects, with full benefits often seen by 6 to 8 weeks. It's important for patients to continue taking them as prescribed even if they don't feel immediate improvement.
What should be done at least once during pregnancy to prevent PPD complications?
a. Blood Sugar
b. Postpartum Blues Screenings
c. Ultrasound
d. Urine Drug Screening
Answer: Postpartum Blues Screenings
Rationale: Women with risk factors for perinatal depression should be monitored. If not done previously women should be assessed for predisposing factors during labor, postpartum stay.
Question: Which antidepressant drugs are safe for a mother that is breastfeeding? (Select all that apply)
a. Citalopram
b. Paroxetine
c. Fluoxetine
d. Sertraline
e. Fluvoxamine
Answer; b, d, and e
Rationale: A review of 34 studies that examined SSRI use in breastfeeding mother-infant pairs found that paroxetine and sertraline usually produced undetectable infant serum levels, whereas fluoxetine appeared more likely to accumulate in nursing infants In addition, the review (arbitrarily) defined elevated infant serum drug concentrations as those that exceed 10 % of maternal concentrations and found that proportion of infants with elevated serum levels of specific drugs was as followed;
Citalopram (n=12 infants) - 17 %
Paroxetine (n= 47 infants) - 2 %
Fluoxetine (n=36 infants) - 22 %
Sertraline (n=60 infants) - 7 %
Fluvoxamine (n=4 infants) - 0 %
True or False
A severe symptom of PPD is when the patient is having suicidal or homicidal thoughts.
Answer: True
What should patients know about stopping antidepressant medications?
a. It makes you feel better when you abruptly stop
b. Stopping suddenly could lead to withdrawal symptoms and relapse
c. You shouldn't talk to your doctor before you stop
d. It's best to talk to your parents about stopping- not your doctor
Answer: B
Rationale: Patients should never stop antidepressants abruptly without medical supervision. Stopping suddenly can lead to withdrawal symptoms and a relapse. Any medication changes should be made gradually with a healthcare provider.
True or False:
If a patient experiences excessive bleeding after childbirth, they are more prone to developing PPD.
Answer: True
Rationale: Excessive bleeding after childbirth known as postpartum hemorrhage, is associated with an increased risk of developing postpartum depression. These lab findings are typically defined as losing more than 500 mL of blood after a vaginal birth or more than 1,000 mL after a cesarean.