Term
| SNRI not as effective as SSRI |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Partial agonist at 5HT1A presynaptic receptors |
|
|
Term
| Does not improve mood/depression |
|
Definition
|
|
Term
| Long term efficacy inconsistent |
|
Definition
|
|
Term
| Use of BZD within last mo. decreases efficacy |
|
Definition
|
|
Term
| Avoid in pts with high risk for suicide |
|
Definition
|
|
Term
| Overdose causes arrythmias |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Adjunctive/Alternative Treatment |
|
Definition
| BZDs, Pregabalin, Atypical Antipsychotics, Trazodone, Mirtazepine, Hydroxyzine, Anticonvulsants, a1 antagonists, a2 agonists |
|
|
Term
|
Definition
| Potential inhibitory effects of GABA (allosteric) |
|
|
Term
| Relief of acute somatic and autonomic symptoms, NOT cognitive symptoms |
|
Definition
|
|
Term
| Avoid hepatic oxidation in liver disease/elderly |
|
Definition
Lorazepam
Oxazepam
Temazepam |
|
|
Term
|
Definition
|
|
Term
|
Definition
Can be life threatening
Seizures |
|
|
Term
|
Definition
Improved memory and cognition
Decreased risk for motor vehicle crashes
Decreased risk of hip ractures |
|
|
Term
| Adjunctive drug with immediate onset similar to BZD |
|
Definition
|
|
Term
| Improved outcomes when used with SSRI/SNRI |
|
Definition
|
|
Term
Use lower doses
Onset 1-2 weeks |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
a1 antagonists
a2 agonists |
|
|
Term
|
Definition
2-4 weeks for effect
4-6 weeks for full effect |
|
|
Term
Panic Disorder
Time to response |
|
Definition
Max effect at 6-12 weeks
(At least 2 weeks at current dose |
|
|
Term
|
Definition
May see therapy at 4 weeks
Medication trial should be 8-12 weeks
Rarely see full remission |
|
|
Term
|
Definition
Delay in treatment effect of 8-12 weeks
Requires VERY close follow up |
|
|
Term
|
Definition
Delay in treatment effect of 10-12 weeks
Minimum of 6 weeks at max tolerated dose |
|
|
Term
| Augment partial response with insomnia |
|
Definition
Sedative hypnotic
BZD
Trazodone
Mirtazapine |
|
|
Term
|
Definition
Ensure trial of 4-6 weeks
Evaluate for comorbidity
Switch to another first line agent or TCA
Add psychotherapy
Add TCA
Add buspirone
Add BZD
Try/add alternative therapy |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| GAD minimum length of therapy |
|
Definition
|
|
Term
| Panic disorder length of therapy |
|
Definition
|
|
Term
|
Definition
| Usually longterm/life-long |
|
|
Term
|
Definition
| Treat for at least 12 mo. after response |
|
|
Term
| OCD minimum length of therapy |
|
Definition
Minimum 1-2 years
Usually lifelong treatment |
|
|
Term
|
Definition
Citalopram
Fluoxetine
Sertraline |
|
|
Term
|
Definition
Paroxetine
BZD in 1st trimester |
|
|
Term
| BZDs can be used as monotherapy |
|
Definition
|
|
Term
| Aerobic exercise improves |
|
Definition
|
|
Term
| Citalopram not as effective as other SSRIs, considered 2nd line |
|
Definition
|
|
Term
| 2nd line panic disorder treatment |
|
Definition
| Citalopram (not as effective as other SSRIs) |
|
|
Term
|
Definition
Citalopram, fluoxetine
(not as effective as other SSRIs) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Decrease perception of anxiety
(Tachycardia, sweating, blushing, tremor) |
|
|
Term
|
Definition
Propranolol 10-80mg
Atenolol 25-100mg |
|
|
Term
Psychotherapy is a MUST
(Cognitive behavioral therapy) |
|
Definition
|
|
Term
| When to start drug therapy in PTSD |
|
Definition
|
|
Term
| PTSD: May decrease nightmares and insomnia |
|
Definition
|
|
Term
|
Definition
| PTSD: May decrease nightmares and insomnia |
|
|
Term
| PTSD: May decrease hypervigilance and re-experiencing symptoms |
|
Definition
Atypical antipsychotics
(Risperidone, Quetiapine) |
|
|
Term
Atypical antipsychotics
(Risperidone, Quetiapine) |
|
Definition
| PTSD: May decrease hypervigilance and re-experiencing symptoms |
|
|
Term
| PTSD: May decrease re-experience symptoms and aggresion |
|
Definition
Anticonvulsants/mood stabilizers
(Divalproex, Carbamazepine, Topiramate, Lamotrigine) |
|
|
Term
Anticonvulsants/mood stabilizers
(Divalproex, Carbamazepine, Topiramate, Lamotrigine) |
|
Definition
| PTSD: May decrease re-experience symptoms and aggresion |
|
|
Term
| Therapeutic doses usually higher |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Clomipramine effective (>SSRI?) |
|
Definition
|
|
Term
| Amitriptyline, imipramine not effective |
|
Definition
OCD
(Less potent and selective inhibition of 5HT reuptake) |
|
|
