Comparison Of Drug Tx & Psycotherapy in the treatment of Depression
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This document discusses and compares pharmacotherapy (medication) and psychotherapy in the treatment of depression. It outlines the diagnostic criteria for major depressive disorder and dysthymia. It then discusses the epidemiology and clinical course of depression before comparing different treatment approaches. Pharmacotherapies discussed include SSRIs, TCAs, and MAOIs. Psychotherapies discussed include cognitive-behavioral therapy and interpersonal therapy.
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This document discusses mood disorders, specifically depression. It provides the DSM-IV criteria for a major depressive episode, including symptoms such as depressed mood, diminished interest, changes in appetite, insomnia, fatigue, feelings of worthlessness, difficulty concentrating, and suicidal thoughts. It also discusses treatment options, focusing on pharmacotherapy. SSRIs are considered a first-line treatment and details are provided about specific SSRIs, their mechanisms of action, indications, and precautions. Risk factors for suicide are briefly covered.
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The document discusses mood disorders like depression and the criteria for major depressive episodes according to the DSM-IV-TR. It then covers treatment options like pharmacotherapy, noting that SSRIs are usually the first choice medication due to their safety profile. Finally, it discusses risk factors for suicide like mental illness, depression, and substance abuse issues.
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The document discusses mood disorders like depression and the criteria for diagnosing major depressive episodes. It then covers treatment options like pharmacotherapy, focusing on selective serotonin reuptake inhibitors (SSRIs) as a first-line treatment. SSRIs are generally well-tolerated but can cause side effects like sexual dysfunction, nausea, headaches, and insomnia. Precautions are discussed around pregnancy, the elderly, children, and drug interactions. Risk factors for suicide are also outlined.
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We'll discuss the treatment of Schizophrenia which includes both pharmacological and psychological intervention. The side effects of antipsychotics are also mentioned related to Central nervous system, cardiovascular system, anticholinergic and metabolism. The psychological intervention is discussed including CBT. The duration of the CBT. The social aspect is also discussed that how patient should be helped by the community.
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Depression is a common mental disorder characterized by depressed mood and loss of interest or pleasure. It is the leading cause of disability worldwide and has a high prevalence among women. Risk factors include genetics, brain chemistry, life stressors, and medical illnesses. Symptoms can range from mild to severe and include feelings of sadness, fatigue, changes in appetite, and suicidal thoughts in more severe cases. Treatment involves antidepressant medication, psychotherapy, or electroconvulsive therapy for severe or treatment-resistant cases. Antidepressants take 2-4 weeks to work and should be taken for at least 6-9 months after an initial episode or for 2 years for recurrent depression to prevent relapse.
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Unipolar depression, also known as major depressive disorder, is characterized by at least two weeks of depressed mood or loss of interest accompanied by other cognitive and physical symptoms. It is a complex disorder that can manifest through emotional, physical, and cognitive symptoms due to involvement of many brain regions. Treatment goals include reducing symptoms, restoring function, and minimizing relapse risk. While SSRIs effectively treat emotional symptoms, dual-acting antidepressants that increase both serotonin and norepinephrine may better treat the full symptom spectrum due to the roles of these neurotransmitters in both the brain and spinal cord. Achieving full remission is important for improving long-term outcomes, as residual symptoms are associated with higher relapse risk.
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Major depressive disorder is one of the most common psychiatric disorders, affecting nearly 17% of the population. It is characterized by depressed mood or loss of interest/pleasure for at least two weeks, along with other symptoms such as changes in appetite, sleep, energy levels, concentration, feelings of worthlessness and thoughts of death or suicide. Biological factors like abnormalities in neurotransmitter systems, hormones, and sleep patterns are implicated in its etiology. Treatment involves medications and psychotherapy.
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This document provides information on mood disorders including major depressive disorder and bipolar disorder. It discusses the diagnostic criteria, symptoms, and treatment approaches for these conditions. The key points are:
- Major depressive disorder involves at least 2 weeks of depressed mood and/or loss of interest plus additional symptoms. Treatment involves medication, psychotherapy, or their combination, with the goal of full symptom remission.
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Depression
Depression
Background
Pathophysiology
• The monoamine theory of depression is that it results from a central deficit in the monoamine neurotransmitters serotonin (5-HT) and norepinephrine.
• Other reported physiological features include ↑cortisol and a blunted TSH response.
• However, there is no widely accepted and definitively proven biological model of depression.
Epidemiology
• Time course: for most it is an episodic illness, but for other it follows a more chronic course.
• Incidence: 5% annual risk, 20% lifetime risk.
Presentation
DSM and NICE criteria
These are based on DSM-4, though DSM-5 does not significantly differ.
Major depressive disorder is ≥2 weeks of low mood and/or anhedonia, and at least 4 symptoms out of:
• ↓Energy or fatigue.
• ↓Concentration
• ↓Weight/appetite.
• Disturbed sleep, which commonly includes early waking. Diurnal pattern to symptoms also seen, with symptoms often worse in the morning.
• Slowing of thought and movements (psychomotor slowing) or agitation.
• Ideas of worthlessness or guilt.
• Recurrent thoughts of death or suicide.
• All but the last 2 are considered 'biological' symptoms.
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The document discusses several types of depression including major depressive disorder, dysthymic disorder, postpartum depression, seasonal affective disorder, and bipolar disorder. It then provides details on the prevalence, risk factors, causes, and screening tools for major depressive disorder. The remainder of the document discusses differential diagnoses, treatment options including pharmacotherapy and psychotherapy, specifics on different classes of antidepressants and their mechanisms of action, side effects, and drug interactions.
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Major depression is characterized by depressed mood and loss of interest or pleasure that lasts at least two weeks. About 15% of people experience major depression in their lifetime. Females experience depression twice as often as males. Depression has genetic, biological, psychological, and social causes. Treatment involves psychotherapy, antidepressant medication, electroconvulsive therapy, or light therapy. Nursing care focuses on safety, support, and education to prevent suicide and promote recovery.
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Depression is underrecognized and undertreated in older adults. It is not a normal part of aging and can worsen medical illnesses. Symptoms include depressed mood, loss of interest, changes in appetite, insomnia, fatigue, guilt, and suicidal thoughts. Depression is diagnosed if five or more symptoms are present for two weeks. Treatment involves pharmacotherapy such as SSRIs or SNRIs for at least six months, psychotherapy like CBT, and other somatic therapies for severe cases. Untreated depression can have serious consequences so screening and treatment is important for older adults.
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: The man whose antidepressants stopped working
Major depressive disorder is one of the most prevalent disorders we will see in our clinical practice. Treatment options for MDD can vary greatly contingent on the appropriate psychopharmacologic interventions being adopted for our clients.
Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients who are prescribed medications for management of chronic conditions (Kleinsinger, 2018). Nonadherence isn't a new problem. However, offering clients valuable interventions and education to overcome any potential compliance barriers will help the provider identify any challenges and decide how to achieve mutually agreed-upon goals to improve their health.
Questions
1.
Do you ever feel that taking your medications is a nuisance or inconvenience? Do you have a difficult time remembering to take your medications or forget?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;Developing a medication schedule, It is difficult to come up with a schedule to take medications every day for some patients. Collaboratively we need to come up with a convenient time to take the antidepressant and the other prescribed medication for them to be effective.
2.
Does your prescribed medications and treatment regimen still leave you feeling depressed? Do you have a difficult time adhering to a prescribed regimen?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;The patient discontinued his Effexor although it appeared to be effective. It is essential to find out the patient’s reason for not following the prescribed regimen and come up with a solution together.
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;It is crucial for the patient to take his antidepressants accordingly, as well as not skip or alter the dosage, nor terminate the medication once you start feeling better.
3.
Have the side effects of your medications been difficult to cope with or manage? Do you sometimes stop taking your medications because of the adverse effects?
Sertraline has been prescribed in the past and discontinued several times. The patient experienced side effects of sexual dysfunction and stopped taking. Encourage the patient to monitor any side effects, physical and emotional changes or occurrences.
Stopping medications and treatment regimens prematurely or abruptly have been associated with high relapse rates and can cause serious withdrawal symptoms (Henssler, Heinz, Brandt, & Bschor, 2019).
Important People
Family members and other caregivers bring personal knowledge on the suitability or lack thereof regarding different treatments for the patient's circumstances and preferences (Smith, 2013). The patient is married, so I would address additional questions to his wife. After getting permission to discuss his medical records with his family members, I would ask the wife if she knew what medications her husband was taking? If she knew why he was taking them? Informed and en.
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