Managing Depression in Clinical Practice (eBook)

Managing Depression in Clinical Practice 3
Contents 5
Author biographies 7
Preface 9
Chapter 1 Classification, causes, and epidemiology 11
Different types of depression 11
Depressive disorders 11
Causes of depression 15
Epidemiology and natural history 18
References 20
Chapter 2 Depression in different types of patients 21
Depression in children 21
Depression in elderly people 22
Depression in women 23
Depression in patients with comorbid medical conditions 24
References 25
Chapter 3 Diagnosis 26
Signs and symptoms of depression 26
Differential diagnosis 28
The patient examination and interview 29
Laboratory tests for co-occurring illnesses 33
References 34
Chapter 4 Principles of therapy 35
Goals of treatment 35
Rating scales for assessment of outcomes 36
Acute treatment outcomes 36
Medium- and long-term treatment outcomes 38
Treatment options 39
Nonspecific effects and placebo 39
Specific treatment options 39
Choice of treatment 40
Thresholds for benefit from specific treatments 40
Choice between specific treatments 42
Practicalities of treatment 43
Evaluation of risk, education, and agreeing treatment 43
Special populations 45
Children and adolescents 45
Elderly people 45
Pregnancy and breastfeeding 46
Initiating treatment 46
Monitoring and adjusting treatment 47
Service structure in delivery of treatment 48
Factors affecting response to treatment 49
References 50
Chapter 5 Medications 52
Selective serotonin reuptake inhibitors 53
Serotonin and norepinephrine reuptake inhibitors 55
Venlafaxine 55
Duloxetine 56
Milnacipran 56
Monoamine receptor antagonist drugs 56
Trazodone and nefazodone 56
Mirtazapine 57
Norepinephrine reuptake inhibitors 58
Reboxetine 58
Dopamine reuptake inhibitors 58
Bupropion (amfebutamone) 58
Tricyclic antidepressants 59
Monoamine oxidase inhibitors 61
Other drugs 62
New compounds 62
Augmentation strategies 63
Specific adverse effects of antidepressants 63
Serotonin syndrome 63
Antidepressant discontinuation syndrome 63
Suicidality 64
References 65
Chapter 6 Other treatments 66
Psychotherapy for depression 66
Combination psychotherapy and psychopharmacotherapy for depression 68
Physical treatments 71
Electroconvulsive therapy 71
Phototherapy 73
Other physical treatments 73
Vagus nerve stimulation 74
Transcranial magnetic stimulation 74
Deep brain stimulation 75
Lifestyle and complementary therapies 75
Exercise 76
St John’s wort 77
Omega-3-fatty acids 77
Acupuncture 78
References 80
Chapter 7 Management of treatment nonresponse 83
Assessment and principles of management 83
Assessment 83
Principles of management 84
Definitions: treatment nonresponse and treatment-resistant depression 85
Medication strategies 86
Dose increase 86
Switching treatment 86
Combining treatments 87
Psychological treatment strategies 88
Physical treatment strategies 89
References 90
Chapter 8 Continuation and maintenance treatment 91
Goals of continuation/maintenance treatment 91
Phases of treatment 91
Medication 92
Psychological treatments 93
Physical treatments 94
Risk factors for relapse and recurrence 94
Longer-term treatment in practice 94
References 96
Index 97