• Pathophysiology

    by  • 07/12/2013 • Psychiatry

    Prevention: behavioural intervention (interpersonal therapy)

    Treatment / management:

    • Psychotherapy = medication should only be offered if psychotherapy has been tried or is currently being used. Psychotherapy includes = CBT, interpersonal therapy, family therapy..

    • Antidepressants = most used are SSRIs (good effect, low s/e’s, and not too toxic, esp in overdosage). Atypical anti-depressant = buproprion. Popular options = venlafaxine, citalopram, fluoxetine. Sedating anti-depressant = mirtazipine.

    • Electroconvulsive therapy (ECT) = pulses of electricity sent into brain by two electrodes – which induce a seizure for a brief period. The pt is under GA.


    • The more episodes of depression = higher risk of subsequent episodes. Lifetime average of 4 episodes.

    • Have a reduced life expectancy due to inc risk of suicide and dying by other causes.

    • Tend to have significant comorbidites = inc risk CVD, ADHD, unexplained pain (somatised?), anxiety, post-traumatic stress disorder

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