Overview

This case presents the history of a 68-year-old male with a distant history of depression who presents to his PCP with an episode of depression. This case will examine the sole use of monoamine agonist antidepressants and their potential to worsen manic-like symptoms of psychomotor excitation. The use of other dopamine blockers and/or lithium for the mixed depressive state and/or suicidality will also be discussed in order to appreciate the risk of suicide among individuals with mixed depression. 

Learning Objectives

  • Identify evidence of mixed depression in the presenting symptoms of this case
  • Compare and contrast risks and benefits of antidepressants versus dopamine blockers in patients with mixed depression
  • Appreciate the risk of suicide in mixed depression and recognize potential benefits of lithium for suicide prevention



Faculty Disclosures

Nassir Ghaemi, MD, MPH

Speaker’s Bureau, Consultant, and Contracted research for Sunovian;  Employee for Novartis Institutes for Biomedical Research. 


Jim Phelps, MD

No financial relationships to disclose. 

Disclosures

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose.

CME Information

CME

AMA PRA Category 1 Credits

Accreditation Statement

pmiCME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Designation Statement

pmiCME designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME

AANP

Accreditation Statement

pmiCME is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners. AANP Provider number 040308. This activity was planned in accordance with AANP Accreditation Standards and Policies.


Designation Statement

This program has been approved for 0.60 contact hour of continuing education, including 0.12 hour of pharmacology. 


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