Postpartum mood syndrome with crying, irritability and euphoria Maternity blues

Postpartum depression - SSRI or psychotherapy. If no CBT, Pick ITP.

Greater than 2 weeks
Heroin least serious WD symptoms compared to alcohol, benzos,
barbs.
o
Cocaine WD isn't that bad either.
Fluvoxamine won't show up if correct answer unless OCD is the
question. It is an SSRI. Used only for OCD. 200-300 mg.
o
Other drugs are also used and need to be at high doses
Clozapine: DIARRHEA is not associated with it. Constipation can
happen
o
Associated with drooling, agranulocytosis, seizures
o
Lowers seizure threshold
Tranylcycropamine plus 5-ht containing supplement - serotonin
syndrome
o
Colorful VH, myoclonic jerks, mild confusion
Second-gen antipsychotics can cause metabolic syndrome but
Aripiprazole and ziprasidone and lorazidone (latuda)
Kids vs. Adults in MDD - kids can be irritable, adults are usually NOT.
Continue antidepressant at the same dose for RECURRENT
DEPRESSION
Acute dystonia secondary to antipsychotic med - GIVE BENADRYL.
o
Or give benztropine.
o
Both are anticholinergic drugs. Can reverse EPS.
Akathisia - give beta blocker (Propranolol)
Parkinsonism - anticholinergic (benztropine)
Tardive Dyskinesia - clozapine can make it better.
Cognitive therapy is good for OCD, phobias, panic disorder
Nicotine most commonly abused substance among patients with
schizophrenia
Antipsychotics have best efficacy for treating Tourettes and other tic
disorders. Haloperidol low dose is probably best
EEG finding in delirium - diffuse slow activity
o
Attention most sensitive finding for delerium
Bipolar 2 disorder: has depressive episodes and HYPOMANIC episodes
(shorter in duration, no hospitalization, no psychosis)
Bipolar 1: mania, psychotic symptoms, bizarre delusions
Anxiety is not part of the "four As" of schizophrenia
o
Four As: Autism, Ambivalence, Loose Associations, Disturbance
of Affect
Agoraphobia benefits from systematic desensitization (exposure
therapy)
Anhedonia is cardinal symptom of MDD
Girl SEEING dead brother after they died is ACUTE STRESS DISORDER
vs. bereavement
Lithium - thyroid and kidney function should be checked

Patient intoxicated on lithium and having impaired consciousnes,

neurmuscular irritability and seizues needs DIALYSIS.
Obsessions are THOUGH CONTENT
Only a judge can determine competency
Beer should be avoided with MAOIs because beer has tyramine
Atypical features of MDD: mood reactivity, heavy feeling in legs
(leaden paralysis), increased appetite, sleeping a lot. Treat w/ MAOI
Phenelzine because they most effective.