1)What other question you would like to ask this patient and give your judgement
-Any thinking of comitting suicide ( 2/3 of depress patient exhibit suicide ideation)
-Abnormal menses? ( depression due to medical condition)
-Terminal illness like cancer, AIDS. (terminal illness patient can lead to depression)
-Early morning awakening (Terminal insomnia- 75% in depressed patient.)
-Any history of the loss of love one before the onset (to exclude depression d/t bereavement)
-Any history of psychiatry problem like depression, manic (recurrent depression or depression in bipolar disorder)
-Hearing any voices, delusion ( presence of psychotic feature in severe depressive episodes)
-Poor family support, broken marriage.
2)Give three biological symptoms that usually present in depress patient
-Sleep disturbance
-Diurnal mood variation
-Loss of appetite, weight
-Constipation
-Loss of libido
-Amenorrhea
-Headache, stomachache
3)Outline the pharmacological treatment for depression.
a)Selective serotonin reuptake inhibitor
-Fluoxetine, sertraline, escitalopram
b)Monoamine oxidase inhibitor (block MAO which break down serotonin and norepinephrine)
- Phenelzine, Isocarboxazid, Tranylcypromine, Moclobemide
c)Tricyclic antidepressent (block reuptake of norepinephrine and serotonin)
- Desipramine, amitriptyline
Newer antidepressent
d)Norepinehrine reuptake inhibitors
e)Norepinephrine dopamine reuptake inhibitor
- Bupropion
f)Serotonin norepinephrine uptake inhibitor
- Venlafaxine, duloxetine
g) Noradrenergic and specific serotogenic antidepressent
- Mitrazapine
to return to the question, click [here]
Reference:1) Kaplan&Sadock’s Pocket Handbook of Clinical Psychiatry 4th edition, Benjamin.J saddock M.D, Virginia, A. saddock, M.D, Lippincott Williams&Wilkins,
2) Pathology Recall, Anikar Chhabra MD, Lorne H. Blackbourne MD, Lippincott Williams&Wilkins, 2002