NUR 2214 Mood Disorder outline Latest 2023 /2024 Depression Major Depressive Disorder – Most common • Anhedonia • Fatigue • Sleep disturbances • Appetite changes • Feelings of hopelessness or worthlessness • Persistent thoughts of suicide or death • Inability to concentrate or make decisions • Change in physical activity Dysthymic Disorder • At least 2 years • Usually presents in adolescent years • Etiology • Assessment • Suicide potential • Affect • Thought processes • Mood • Feelings • Physical behavior • Communication 1 / 3
• Religious beliefs and spirituality
• Treatment Phases • Acute Phase • 6-12 weeks • Continuation Phase • 4-9 months • Maintenance Phase • 1 year + • Nursing Interventions • Communication • Health teaching and health promotion • Promotion of self-care activities • Teamwork and safety • Pharmacological • Antidepressants • Selective Serotonin Reuptake Inhibitors (SSRIs) • Citalopram (Celexa) • Escitalopram (Lexapro) • Fluoxetine (Prozac) • Paroxetine (Paxil) • Sertraline (Zoloft) 2 / 3
• Tricyclic Antidepressants (TCAs) • Amitriptyline (Elavil) • Protriptyline (Vivactil) • Monoamine Oxidase Inhibitors (MAOIs) • Isocarboxazid (Marplan) • Phenelzine (Nardil) • Tranylcypromine (Parnate) • SSRIs • First line therapy • Fewer side effects • Common side effects • Agitation, anxiety, sleep disturbance, tremor, sexual dysfunction, tension headache • Serotonin Syndrome • Discontinue 2-5 prior to beginning MAOIs • Abdominal pain, diarrhea, sweating, fever, tachycardia, elevated BP, ALS, myoclonus, increased motor activity, irritability, hostility, mood change • REALLY BAD – hyperpyrexia, cardiovascular shock, death
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