MDD and ECT

Question 1

What mental health disorder is the leading cause of disability worldwide?

Answer 1

MDD

Question 2

What is SIGECAPS?

Answer 2

Sleep, interest, guilt, energy, concentration, appetite, psychomotor retardation, suicide

Criteria for MDD 5 symptoms in 2 weeks

Question 3

What neurotransmitters are involved in MDD?

Answer 3

Dysregulation of dopamine, norepinephrine, and serotonin

Question 4

What is pseudodementia?

Answer 4

MDD in older adults that is often confused with dementia

Question 5

First line treatment for MDD?

Answer 5

SSRI

Question 6

Psychoeducation for SSRIs

Answer 6

4-6 weeks to show positive effects

Question 7

All antidepressants carry a black box warning for what?

Answer 7

Increased suicidal thoughts for patients under 24 years old

Question 8

Discontinuation syndrome is more common in what medications?

Answer 8

Effexor and Sertraline due to shorter half-life

Question 9

If TCAs are more effective for depression, but should we prescribe them over SSRIs?

Answer 9

NO - they are less safe than SSRIs. TCAs can have cardiac dysrhythmias and high risk discontinuation syndrome.

Question 10

TCAs should be completely avoided in which patients?

Answer 10

Those with suicidal ideation

Question 11

Wellbutrin increases which neurotransmitter?

Answer 11

Dopamine and Norepi

Question 12

SSRIs increase which neurotransmitter?

Answer 12

Serotonin

Question 13

MAOIs increase which neurotransmitter?

Answer 13

Dopamine, norepi, and serotonin

Question 14

TCAs increase which neurotransmitter

Answer 14

Serotonin and norepi

Question 15

Non-pharmacological management of MDD?

Answer 15

ECT, CBT, TMS, VNS, phototherapy, interpersonal theory

Question 16

Prozac offers the greatest benefit for patients with severe depression because of what?

Answer 16

Low risk of injury in cases in intentional OD

Question 17

Which SSRI provides reduced potential for drug-drug interactions?

Answer 17

Lexapro

Question 18

What is ECT used for?

Answer 18

MDD with psychotic features, treatment-resistant depression

Question 19

Contraindications for ECT

Answer 19

Cardiac disease, compromised lung status, history of brain injury or tumor, intolerance of anesthesia

Question 20

Adverse effects of ECT

Answer 20

Most common: short term memory disturbance
Cardiac arrhythmia, headache, muscle ache, and drowsiness