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Part II ISQ Club - Depression

24 posts in this topic

20 Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

1. Dexamethasone non-suppression is seen in 90% of depressives

2. Lithium acts via the second messenger system

3. Fluoxetine increases the levels of benzodiazepines

4. St. John’s Wort reduces the efficacy of oral contraceptive pills

5. Depression causes reduced REM latency

6. If a person has depression in summer, you cannot diagnose seasonal affective disorder

7. Sadness is recognised better by looking at the face than listening to the voice

8. Melatonin hypersecretion is reliably proven in seasonal affective disorder

9. MAOIs reduce the efficacy of oral hypoglycemic drugs

10. The gender difference in depression is exaggerated as we grow older

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3) Fluoxetine increases the levels of benzodiazepines

True

Fluoxetine inhibits cytochrome CYP3A4 which blocks benzodiazepine oxidation in the liver and so potentiates the effects. (p361)

All SSRIs can inhibit CYP IID6, the enzyme most commonly involved in drug metabolism, usually as a hydroxylase. Fluoxetine and paroxetine are the most potent inhibitors, sertraline is a moderate inhibitor and fluvoxamine and citalopram have virtually no effect at normal clinical doses. Potential interactions are numerous, but few are clinically important. (p265)

Use of Drugs in Psychiatry; Cookson, Taylor & Katona; 5th Edition; Gaskell

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NO 4)TRUE

ST johns wort is an enzyme inducer ,hence interferes with efficacy of OCP

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5. Depression causes reduced REM latency

TRUE

(Pg 225, Oxford Txtbk of Psy, 3rd Ed, Gelder et al)

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8. Melatonin hypersecretion is reliably proven in seasonal affective disorder

FALSE

(Pg 206, Oxford Txtbk of Psy, 3rd Ed, Gelder et al)

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10. The gender difference in depression is exaggerated as we grow older

FALSE

(Pg 737, Comp to Psych Studies, 6th Ed, Johnstone et al)

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6 false the seasonal episodes have to outnumber the non seasonal ones . ox txtbk  ch 4.3.2

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9. MAOIs reduce the efficacy of oral hypoglycemic drugs

FALSE

(Pg 647, BNF)

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2. Lithium acts via the second messenger system

TRUE

(Pg 1047, Synopsis of Psych, 8th Ed, Kaplan & Sadock)

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1. Dexamethasone non-suppression is seen in 90% of depressives

FALSE

50% (Pg 224, Oxford Txtbk of Psy, 3rd Ed, Gelder et al)

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1.F- 50% Malhi Basic Sciences Appendix five

2.T- it inhibits Inositol phosphate metabolism( Kaplan and Sadock 1994- P 962)

3.F-? It increase plasma level of clozapine,Halperidol and zotepine but not BZD (BNF P628)

4.T-BNF (P658)

5.F- increase REM Latency

6.F- Can be living in southern hemisphere

7.T- more clues picked by seeing rather then just hearing

8.F- not reliablely found.

9. T-BNF P647

10. F- There is still more depressed females above 65 .

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Q.3- flouxetine increases levels of BZD

some antidepressants are 3A4 inhibitors including SSRI,s fluoxetine and fluvoxamine and the antidepreesant nefazodone and will increase the levels of alprazolam or triazolam (substrates) requiring dose reducation of the BZD

(REF- stahl psychpharmacology)

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Q.9- F .MAOI reduce efficacy of oral hypogycaemic drugs

MAOIs may worsen hypoglycaemia and require readjustment of the dosage of hypoglycaemic agents

Ref- New oxford textbk

Q.5 Depresion causes reduced REM latency- T

Sleep and manipulations of the sleep–wake rhythm in depression (acta psychiatrica scandinavica-berger et al

investigations in unmedicated depressed patients using operationalized diagnostic criteria -suggests besides disturbances of sleep continuity a reduction of slow wave sleep (SWS) and a shortening of the interval between sleep onset and the occurrence of the first random eye movement (REM) period (i.e. REM latency) was documented. Additional abnormal features included an increase of REM sleep, a prolongation of the first REM period and a heightened number of eye movements during REM periods (i.e. REM density) Initially, reduced REM latency was postulated to be a biological marker for primary depression  Further research on this issue did not confirm this assumption – disinhibition of REM sleep has now also been observed in non-melancholic and secondary depression and in other psychopathological conditions

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7. Sadness is recognised better by looking at the face than listening to the voice

false. otherway round

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10. The gender difference in depression is exaggerated as we grow older

false. become less

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3.False

BNF Plasma concentrations of some benzos increased

by fluvoxamine.

Could be True if the question is SSRIs?

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9.False

BNF Hypoglycaemic effect of insulin,metformin and sulphonylures enhanced by MAOIs

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7. Sadness is recognised better by looking at the face than listening to the voice

false. otherway round

this is false.you may have depression and yet smile,the so-called smiling depression.yet,the voice can give you away,unless you are a great actor.

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