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Depression 411

Depression

QuestionAnswer
Significant reduction in depressive symptoms. 50% reduction in depression rating scale score. Response
Reduction of depressive symptoms to the point that the pt is virtually asymptomatic. HAM-D<7. Remission
Goal of Therapy Treatment to Remission
Sustained remission > 6 months Recovery
Return of depressive symptoms before achieving recovery Relapse
Successive episode of MDD after recovery from initial episode of MDD Recurrence
Initial 6-12 wks of treatment, initial response and remission is typically achieved Acute Phase
Treatment bridging remission to recovery. 6-9 mos Continuation phase
Continuation of AD at full therapeutic dose for extended periods of time. Maintenance phase
Inhibit serotonin transporter SSRI's MOA
Most frequently used AD's SSRI's
Dosed once a day SSRI's
Typically given in morning, but can be given at any time of day SSRI's
Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram, Fluvoxamine SSRI's
activation, sedation, sleep disturbances, sexual SE's, weight gain SSRI's ADR's
Inhibit neuronal reuptake of 5HT and NE SNRI's MOA
Nausea, GI complaints, insomnia, sexual SE's, increased BP, sweating, agitation SNRI's ADR's
Inhibition of DA and NE reuptake Bupropion MOA
Lowers seizure threshold, contraindicated for pts with seizure disorder Bupropion
Low incidence of sexual SE's, lack of serotonergic activity Bupropion
Enhances NE and 5HT activity Mirtazapine (Remeron) MOA
Sedating, take at bedtime Mirtazapine (Remeron)
Significant weight gain Mirtazapine (Remeron) ADR's
Inhibition of NE and 5HT reuptake to various extents Tricyclic AD's MOA
Lethal in OD, caution in suicidal pts Tricyclic AD's
Enhances 5HT activity Trazodone
Very sedating-used to treat insomnia at low doses Trazodone
Older agents not used much anymore, lots of interactions and SE's MAOI's
Venlafaxine, Duloxetine SNRI's
Created by: lbreimeir
Popular Pharmacology sets

 

 



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