Mood Disorders
A 35-year-old man reports feeling “on top of the world” for 7 days. He sleeps only 3–4 hours per night, talks rapidly, jumps between ideas, and spends large sums impulsively. Afterward, he has a 2-week period of depressed mood, low energy, and loss of interest in activities.
Bipolar I
A 45-year-old woman believes her neighbor is secretly in love with her and sending hidden messages through TV broadcasts. She has held this belief for over 2 months. She continues to work and function normally, and her behavior is otherwise appropriate. She denies hallucinations or mood symptoms.
Delusional Disorder
A 32-year-old man started an SSRI 6 weeks ago for depression. His mood has improved, but what is the side effect he is most likely to report?
SSRI-induced sexual dysfunction
Lithium is an ion that is used as a mood stabilizer for this disorder?
Bipolar Disorder
How long do SSRIs and SNRIs take to achieve maximum effect?
weeks to months
A 30-year-old man has low mood and fatigue for the past 3 years, most days, with poor appetite, low energy, and low self-esteem, but never had a period of full symptom remission longer than 2 months. He denies mania or hypomania.
Persistent depressive disorder (dysthymia)
A patient has persecutory delusions and hallucinations for the past 3 years. 6 months ago he started having sadness, guilt, insomnia, decreased concentration, and sleep issues
Schizoaffective disorder
A 30-year-old woman recently started a new antidepressant and now presents with agitation, sweating, diarrhea, and tremor. On exam, she has hyperreflexia and myoclonus.
Serotonin Syndrome
What drug class do fluoxetine and paroxetine belong to?
SSRI's
A 13-year-old boy is repeatedly lying, stealing, and setting fires at home and school. He has bullied classmates, and shows no remorse for his actions. These behaviors have persisted for over a year.
Conduct disorder
A 26-year-old woman has recurrent depression and periods of increased energy, decreased need for sleep, and productivity lasting 4 days, but she remains functional and has never been hospitalized.
Bipolar II
A 30-year-old woman suddenly becomes agitated, talks incoherently, and has persecutory delusions for 5 days after a stressful breakup. She is confused but returns to baseline functioning afterward.
Brief Psychotic Episode
A 40-year-old man with schizophrenia is started on an antipsychotic. Two days later, he develops fever, severe muscle rigidity, confusion, and sweating. Exam shows lead-pipe rigidity and elevated CK.
Neuroepileptic Malignant syndrome
What drug class does Haloperidol belong to?
An 80-year-old man is hospitalized for pneumonia. Overnight, he becomes confused and agitated, doesn’t know where he is, and has fluctuating levels of consciousness and severe inattention. His family says he was normal yesterday.
Delirium
A 24-year-old woman has 3 months of low mood. She sleeps 11 hours daily, has increased appetite with weight gain, and feels her arms and legs are “heavy.” Her mood improves when with friends but she is very sensitive to rejection.
MDD Atypical
A 24-year-old man develops auditory hallucinations, paranoid delusions, and disorganized speech over the past 3 months. He has no prior episodes and his work and social functioning were previously normal.
Schizophreniform Disorder
A 25-year-old man with schizophrenia is started on haloperidol. Two days later, he develops sustained neck and eye muscle contractions, making it difficult to move his head. He is restless and paces constantly, and his speech is slightly slowed with a shuffling gait.
Which medication could be used instead to treat his psychosis while minimizing these side effects?
Atypical Antipsychotic
What drug class do imipramine, desipramine, and clomipramine belong to?
Tricyclic antidepressants (TCAs)
A 28-year-old woman presents with sudden inability to move her right arm after a stressful argument with her boss. She appears distressed but unconcerned about her symptoms. Neurologic exam and imaging are completely normal. There is no history of trauma or medical illness to explain her weakness.
Conversion Disorder (Functional Neurological Symptom Disorder)
A 22-year-old college student reports intense fear of public speaking and meeting new people. She avoids class presentations and social gatherings because she fears embarrassment or being judged, even though she knows her fear is excessive. Symptoms have persisted for over a year.
Social Anxiety Disorder
A 26-year-old man is brought in by his roommate. Over the past 8 months, he has become withdrawn, rarely leaves his apartment, and has neglected his hygiene. He reports hearing voices commenting on his actions, which he finds distressing but sometimes tries to ignore. His speech is mildly disorganized, and his affect is blunted.
What brain pathway is related to his auditory hallucinations?
Mesolimbic
A 25-year-old man with schizophrenia is started on haloperidol. Two days later, he develops sustained neck and eye muscle contractions, making it difficult to move his head. He is restless and paces constantly, and his speech is slightly slowed with a shuffling gait.
What is the mechanism that is causing his symptoms?
ESP D2 Blockase
Which atypical antidepressant may cause seizures in anorexic / bulimic patients?
Bupropion
What condition is treated with the drug Galantamine?
Alzheimers Disease