Clear FMGE 2023 with the help of Kings
Kings International Medical Academy is presently offering rigorous FMGE classes for the upcoming exam, which feature highly qualified faculty members in the medical field. In a recent session, Dr. Mohan Sunil Kumar delivered a lecture on Psychiatry. Let’s learn about Atypical Depression in this article.
Atypical Depression
Tx - MAD inhibitors
Doesn't respond to Tri carboxylic Antidepressants
Common – 5 to 15 %
Chronic – 1 ½ month - I ½ Years
6M - 9M
Recurrent:
1 - 50%
2 – 70%
3 – 90%
Resistant – 1 - 20% won’t respond to Medical Mgmt.
40s - 1 death (world)
4m - 1 death (India)
11. 3 - suicide rate
M >> F 2: I - Death ratio
Mood Disorder – 15%
Schizophrenia - 10 - 12%
Substance use – 10%
Anorexia Nervosa – 10%
Borderline PD – 10%
HOPELESSNESS - Important Risk Of suicide
↓ Risk of suicide – Lithium, Clozapine
Emergency Best - Electroconvulsive Therapy
Paradoxical Suicide - ↑ suicidal Ideas
| Chemicals | cognition | conflicts |
| ↓ 5HT , ↓ NE ↓ Dopamine ↓ BDNF – Brain-derived neurotrophic factor ↓5HIAA - 5-hydroxyindoleacetic acid |
Aaron Beck Cognitive Triad 1. Hopelessness 2. Worthlessness 3. Helplessness |
Grief ambivalence Anger turned inwards Interojection |
Tx - Antidepressants ↑ 5HT, ↑ NE, ↑ Dopamine
SSRI – Escitalopram
Citalopram
Fluoxetine
Sertraline
Paroxetine
Fluroxamine
S/E
Nausea, vomiting
Diarrhoea
GI Distress
Vivid dreams
Sexual S/E – Libido ↓, Erection ↓
Delayed Ejaculation, Anorgasmia
Anti. Depressants w/o sexual S/E
Bupropion
Vorfioxetine
5HT1B partial Agonist
5HTIA Agonist
5HT transporter inhibitor
5HTID Agonist
5HT3 Agonist
5HT7 Agonist
Augmentation
Low Dose – Lithium
Management
1. Pharmacological
2. Psychological
ECT - shock Rx
Modified ECT
Indication
