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MDD dx requirements
5+ symptoms must present for at least 2 weeks (suicidal ideation, diminished interest, guilt, loss of energy, low concentration, appetite changes, psychomotor agitation or retardation, sleep changes)
continuation phase of treatment of MDD
4-9 months, goal: eliminate residual symptoms, prevent relapse
first line therapy for MDD
SSRIs, SNRIs, buproprion, mirtazapine (if one doesn't work, try another 1st line)
insomnia, decreased appetite, anxiety, may reduce seizure threshold, minimal to no sexual dysfunction
anticholinergic, antihistaminic, antiadrenergic, cardiac conduction abnormalities, sexual dysfunction, can be fatal in OD
MAOI diet/drug restrictions
aged cheeses, cured meat, tap beer, sauerkraut, pseudoephedrine, dxm, stimulants
overstimulation of 5HT1A receptors, occurs within 24 hours after OD or beginning of tx, can be fatal, DC TX
serotonin syndrome triad of symptoms
mental: altered consciousness, elevated mood
autonomic: diaphoresis, hyperthermia, tachycardia
neurological: tremors, chills, rigidity, hyperreflexia
lithium, buspirone, triiodothyronine, antipsychotics (aripiprazole, quetiaprine, olanzapine/fluoxetine)
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