22 Psychological medicine
Questions
What investigations are recommended in a 70-year-old patient presenting with auditory and visual hallucinations with amnesia?
Can you please explain to me what changes take place in the body to cause a person to have chronic fatigue syndrome (CFS). I am having difficulty understanding the pathology of this condition.
Does tolerance develop to the hypnotic effect of trazodone and mianserin? Do these play a role in the treatment of primary insomnia?
Can you suggest possible causes for a 55-year-old female waking regularly at midnight three to four times a month, feeling that she is going to die and feeling an urge to meet people at that time. She has no breathlessness.
What is the modern treatment and prognosis for manic depressive disorder? Is there a malfunction of a metabolic pathway that causes it? Can it be remedied by treatment with neurotransmitter-stimulating drugs? If so which drugs are the most effective apart from lithium carbonate and carbamazepine?
Is it safe to prescribe lithium for a patient with bipolar mood disorder with biliary cirrhosis and 40% blockage of the main coronary system?
How long should the period of active and maintenance treatment last with mood stabilizers in a patient presenting with his first manic episode?
Can any of the antipsychotics clozapine, olanzepine and quetiapine be used as mood stabilizers in bipolar affective disorder?
Is hypothyroidism secondary to chronic lithium therapy in the treatment of bipolar affective disorder, reversible on discontinuation of lithium or its substitution by another mood stabilizer?
In bipolar affective disorder in patients who are well controlled on lithium, is it possible to prescribe thiazide diuretics when hypertension is difficult to control?
I would like to know when and where antidepressants are used, because I am confused with selective serotonin re-uptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) and tricyclics.
You have written that the serotonin syndrome results from sudden discontinuation of selective serotonin re-uptake inhibitors (SSRIs) with a short half-life, whereas other books I have read say that serotonin syndrome results from an overdose of SSRI or from combination with monoamine oxidase inhibitors (MAOIs) or serotonin agonists. Please clarify.
How frequently should patients receiving chronic lithium therapy be evaluated for thyroid and renal function?
Is buspirone as effective as serotonin re-uptake inhibitors (SSRIs) in the treatment of a generalised anxiety disorder?
Can diethylpropion be used to treat children with attention deficit hyperactivity disorder (ADHD)? If so, what is the recommended dose and at what age can it safely be administered?
Can khat (norpseudoephedrine) be given to children with attention deficit hyperactivity disorder and, if so, from what age?
Are selective serotonin re-uptake inhibitors (SSRIs) and venlafaxin effective in the treatment of attention deficit hyperactivity disorder (ADHD)? How efficient are they in comparison with imipramine?
1. Why is weight monitored in infants on methylphenidate for the treatment of attention deficit hyperactivity disorder (ADHD)? Is this to prevent them losing weight, or is losing a certain amount of weight acceptable?
2. Should the electroencephalogram (EEG) be monitored in patients on methylphenidate for ADHD treatment? Should this be stopped if there is some epileptic discharge?
What is the safest typical and atypical antipsychotic, antidepressant and serotonin re-uptake inhibitor (SSRI) used to treat obsessive-compulsive disorder (OCD) that can be used during pregnancy?
What is the rationale for combining serotonin re-uptake inhibitor (SSRIs) and clomipramine in patients with obsessive-compulsive disorder (OCD)? Is this combination more effective than any agent when given alone?
Is sertraline superior to fluoxetine in the treatment of obsessive-compulsive disorder and, if so, why?
I want to find out if there is really a correlation between all cases of delirium tremens (DT) and thiamine deficiency. DT is meant to be a withdrawal state and I assume it can happen in well-nourished alcoholics, as not all alcoholics are malnourished. My friends and I have seen the question that DT is associated with thiamine deficiency in question papers and it has really proved a thorny issue.
Is there a rationale for treating a patient presenting with his first psychotic episode fulfilling the criteria for schizophrenia, with atypical antipsychotics?
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