Term
| What are the simple classifications of mental illness? |
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Definition
Neurosis: phobias, global anxiety, panic attacks
Character Disorders: obsessive-compulsive, paranoid, sociopathic
Affective Mood Disorder: Depression, Bi polar affective disorder
Psychosis (last two are our focus) |
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Term
| What conditions can be created from excessive/deficient amounts of dopamine lead to? |
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Definition
Too much: Psychotic behavior (extrapyramidal motor system)
Too little: Parkison's symptoms (limbic cortex issue) |
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Term
| Where is serotonin found and what does it do? |
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Definition
| Prominent in the midbrain and brainstem, especiallly the pons, involved with visceral control of sleep, temperature of body, appetite, and neuroendocrine balance. |
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Term
| Where is GABA usually involved and what does it do? |
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Definition
| Present in many areas of the CNS, usually inhibts neuronal depolarization, makes neuronal discharge less likely (for example, in the basal ganglia, inhibits movement) |
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Term
| What are some key concepts of depression and what are the three major types? |
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Definition
Exists in a full spectrum of severity, commonly undiagnosed, commonely treated inadequately, causes significant compromise of lifestyle, and increases risk of suicide/homicide significantly
Reactive (secondary endogenous): adjustment disorder with depressed mood (loosing a close friend or family member), cleared up at about 6 weeks
Endogenous: Major depressive disorder (lasts for over a year or more), no real explanation for the depressive state (NT imbalance)
Bipolar affective disorder: manic-depressive illness, periods and months of depression, then months of manic state etc. |
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Term
| What are the symptoms of Depression? |
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Definition
Lowered mood, sadness, difficulty in thinking and concentrating, loss of intrest, diminished involvement in work and recreation.
In more severe cases, suicidal ideation, psychomotor retardation or agitation, physical symptoms of anorexia, weight loss, insomnia, somatic complaints etc. |
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Term
| How have we managed depression over the years? (1900-now) |
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Definition
1899 - Torture
1920 - Psychoanalysis
1930 - Shock Treatment with insulin and electricity
1950 - MAO INhibitors
1960 - Tricyclic Antidepressants
1990 - SSRI's (selective serotonin reuptake inhibitors) and atypical agents |
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Term
| What are the similarities and differences in general over the different types of anti-depressant drug classes? |
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Definition
Similarities: All have equal potential effectiveness, all require about 4-6 weeks for a significant effect to occur
Differences: The side effects, and safety (some have the ability to give a fatal overdose!) |
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Term
| Are there any safe anti-depressants for pregnant women? |
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Definition
| NO. Recent link of SSRI's to neonatal jitteriness, irrritability, feeding disorders, hypoglycemia, hypotonia, and respiratory distress |
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Term
| What are SSRI's (selective serotonin) used for? What are the side effects? |
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Definition
Treat chronic depression, eating disorders, obsessive-compulsive disorder, panic attacks, and premenstrual syndrome (PMS)
Takes about 2-6 weeks to get into full effect, similar effectivness to other ant-depressants, but essentially no risk from intential overdose, better side-effect profile
Side effects include sleep disturbances, appetite changes (usually increased), sexual dysfunction (diminished drive, orgasmic dysfunction) |
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Term
| What is the biggest potential risk for taking anti-depressants? |
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Definition
Increased energy for potential suicidal risks!
using antidepressants in young patients, teens and adults <25, the suicide risk is much higher than any other groups!...May be due to the increase in impulsive behavior. |
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Term
| What is bipolar affective disorder? Describe a "manic," phase. |
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Definition
Disorder characterized by episodes of depression (often severe) alternating with periods of manic behavior.
Manic phase: agitated, energetic, euphoric, grandiose ideation, easily distractedm hyperactive, requries little sleep, may include psychotic symptoms (litiuhm carbonate to stop this phase) |
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Term
| What is psychosis and what is it characterized by? |
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Definition
| Diminished capacity to recognize reality. Characterized by delusions, hallucinations, abnormal cognition (genius is not excluded!!) |
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Term
| What is the most common type of psychosis and what is it characterized by? |
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Definition
Schiizophrenia. Peak age of onset is teen years and early 20's, chronic and often progressive mental illness.
Characterized by social withdrawal, decline in personal hygiene, flight of ideas, autistic absoprtion in inner thoughts, concrete thinking and difficulty with abstract thought, delusions, hallucinations |
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Term
| What is the dopamine excess theory of psychosis? |
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Definition
| Theory of treating psychosis, using medication to block dopamine (D2) receptors, and it seemsto help people with schizophrenia, but not a complete theory, but best developed at this moment. |
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Term
| What kind of side effects do high/low potent 1st generation antipsychotic drugs produce? |
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Definition
High: Parkinson-like symptoms
Low: produce sedation, hypotension, autonomic side effects |
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Term
| What type of side effects have come from 2nd generation antipsychotic drugs? |
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Definition
| Minimal extrapyramidal effects (atypical). Major problems include wieght gain, type II diabetes, hyperlipidemia |
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Term
| What are the side effects for these antipsychotic effected areas? |
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Definition
Extrapyramidal: parkison like syndrome, tardive dyskinesia
Antimuscarinic: dry mouth, blurred vision, constipation, urinary retention
Alpha Adrenergic: orthostatic hypotension, ejaculatory dysfunction
Dopamine Inhibition: hyperprolactinemia, glactorrhea, gynecomastia |
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Term
| What did the CATIE cases prove to us? |
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Definition
No clear superior antipsychotic drug...
Olazapine had the best effectiveness and continuation but had the worst side effects of all the drugs. Therefore, the more effective, the higher the side effects assumed. |
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