Common Questions About the Pharmacologic Management of Depression in Adults.

Common Questions About the Pharmacologic Management of Depression in Adults. Am Fam Physician. 2015 Jul 15;92(2):94-100 Authors: Kovich H, DeJong A Abstract One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving remission, with a number needed to treat of seven or eight for selective serotonin reuptake inhibitors and seven to 16 for tricyclic antidepressants. The benefit of antidepressants over placebo is more pronounced in patients with severe depression. Second-generation antidepressants are generally considered first-line therapy. Specific therapy choice should be based on cost, patient preference, and adverse effect profile. About two-thirds of patients receiving second-generation antidepressants experience at least one adverse effect during treatment. Nausea and vomiting are the most common reasons for discontinuation of therapy. The optimal treatment duration is unclear, but clinical guidelines suggest four to 12 months for an initial episode of major depression. Patients with recurrent depression may benefit from prolonged treatment. High-quality evidence is lacking on the benefits and harms of antidepressant use in pregnancy. It is unclear whether selective serotonin reuptake inhibitor use in breastfeeding ...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research