1What treatments should be considered for a pt w/ GAD?
buspirone
lorazepam
paroxetine
hydroxyzine
venlafaxine ER
2What does the monoamine-deficiency therory detail?
Insufficient serotonin, norepinephrine, and/or dopamine causes depression
3How does escitalopram work?
Increases serotonin in the synapse by blocking the presynaptic reuptake of the neurotransmitter into the presynaptic neuron
4When a pt calls to report GI symptoms after starting a SSRI 4 days ago, what advice should be provided?
Continue the medication as this should subside
5What should the clinician do when the pt is not fully responding to the initial dose of a SSRI?
Increase it and evaluate in 1 month
6What is one way to offset the side effect of feeling tired with initiation or dose adjustments of a SSRI?
Switch the dosing to HS
7A pt with depression and/or anxiety should remain on treatment for what length of time to prevent relapse of symptoms?
12 mo
8What treatment options should be considered for a pt w/ a specific phobia?
Exposure therapy
CBT
Benzodiazepines to rapidly control symptoms
9What treatment options should be considered for a pt w/ social phobia?
venlafaxine ER
paroxetine
sertraline
10What treatment options should be considered for a pt w/ panic disorder?
sertraline
clonazepam
alprazolam
venlafaxine ER
fluoxetine
11What treatment options should be considered for a pt w/ agoraphobia?
CBT
SSRI
SNRI
Exposure Therapy
12What treatment options should be considered for a pt w/ trichotillomania?
SSRIs
13What treatment options should be considered for a pt w/ OCD?
CBT
clomipramine
SSRIs
(SGA are not first line)
14When treating OCD, what should the clinician do before adding a SGA?
Maximize SSRI first
15What treatment options should be considered for a pt w/ PDD?
paroxeitne
fluoxetine
sertraline
16What treatment options should be considered for a pt w/ MDD?
fluoxetine
escitalopram
sertraline
17What treatment options should be considered for a pt w/ dysthymia?
sertraline
fluoxetine
citalopram
18A pt w/ schizoaffective disorder depressive type will present w/ what symptoms?
Symptoms associated w/ a major depressive episode that is present a majority of the time
Postitive symptoms for >2 weeks in the absence of the major depressive or manic episode
An uninterrupted period of a major mood episode (depressive or manic) & aligns w/ criteria for schizophrenia
19What are the first-line treatment options for schizoaffective disorder?
SGAs
20A pt w/ hypomania will present w/ what symptoms?
At least 4 days of symptoms that appear "abnormal" and "persistent" which have a elevated, expansive, or irritable mood with increased activity or energy
3+ of the following with the mood/activity changes: inflated self-esteemrandiosity; decreased need for sleep; more talkative/pressure to keep talking; flight of ideas/thoughts racing; distractability; increased goal-directed activity/psychomotor agitation; >risk taking behaviors
21What are the first-line treatments for BPII?
SGA/Mood Stabilizers
22A pt has had at least 3 manic episodes in the past and presents to the office with a major depresssive episode. What is your dx?
BPI, depressed
23A pt w/ BPI current episode depressed will present w/ what symptoms?
-H/O at least one episode of mania (1+ week of symptoms)
-For 2+ weeks: 5+ symptoms of major depressive episode (depressed mood or loss of interest/pleasure must be present): change in wt >5% from baseline, insomnia/hypersomnia, psychomotor agitationetardation, fatigue/<energy, feelings of worthlessnessuilt, poor concentration/indecisiveness, recurrent thoughts of death or suicidal ideation
24What are the first-line treatments for BPI w/ a depressive episode?
SGAs: lurasidone, quetiapine, olanzapine/fluoxetine
25A pt w/ cyclothymia presents with what sympotms?
2 yrs of hypomanic episodes (never w/o symptoms for >2 mo)
No mania, major depressive episode, or true hypomanic episodes noted in history (none meet full criteria)
**think chronic fluctuating mood involving both hypomanic symptoms or depressive symptoms that are not "as severe" as bipolar
26What is the first-line treatments for a pt w/ cyclothymia?
SGAs: lurasidone, quetiapine, olanzapine/fluoxetine