First-line medications used in the treatment of depression include Serotonin Reuptake Inhibitors (SSRIS) such as Zoloft/Sertraline, Lexapro/Escitalopram, and Prozac/Fluoxetine.
What are the different kinds of Medicine for depression?
There are different kinds of medicine for depression. Selective Serotonin Reuptake Inhibitors (SSRI) Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) Tricyclic and Tetracyclic Antidepressants
What is the first line antidepressant drug?
The selection of antidepressant medications may be based on patient specific and drug specific factors, as given in Table-7. In general, because of the side effect and safety profile, selective serotonin reuptake inhibitors (SSRIs) are considered to be the first line antidepressants.
What are the clinical practice guidelines for the pharmacological treatment of depression?
Clinical practice guidelines for the pharmacological treatment of depression: Recommendations. All CPGs indicated serotonin selective reuptake inhibitors (SSRIs) as an option for first-line treatment for depression, and the recommendations were based on high-quality studies; however, most CPGs did not cite specific drugs.
How effective are SSRI's for depression?
In the biggest systematic review to date, it appears that selective serotonin reuptake inhibitors (SSRI’s), on average, have a small, but not clinically significant impact on depressive symptoms (Jakobson, 2017).
What is the first-line treatment for depression?
People with severe major depression usually need to be seen by a psychiatrist and sometimes need to be hospitalized. Choosing an antidepressant — For the initial treatment of severe depression, we use serotonin-norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs).
Are generally considered 1st line treatment for depression?
Main Points. Consider sertraline and escitalopram as first-line agents for initial treatment of major depression in adults. The least tolerated antidepressants in this study were bupropion, fluoxetine, paroxetine, and duloxetine.
What are the different types of biological treatments for depression?
Biological treatments for depression involve antidepressant drugs. Examples are MAOIs, tricyclics and SSRIs. These drugs work by changing the brain's chemistry, especially monoamines like serotonin and noradrenaline. SSRIs like Prozac work by preventing the reuptake of serotonin in the synapse.
Which medication was one of the first used to treat depression?
The 1950s saw the clinical introduction of the first two specifically antidepressant drugs: iproniazid, a monoamine-oxidase inhibitor that had been used in the treatment of tuberculosis, and imipramine, the first drug in the tricyclic antidepressant family.
Is SSRI the first-line?
The 2009 National Institute for Health and Care Excellence guidance12 and the British Association for Psychopharmacology (BAP)7 suggest an SSRI should be considered first, unless there is a history of poor response or unacceptable side effects with SSRIs.
Are SNRIs first-line for depression?
SNRIs can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. The SNRIs also have an important role as second-line agents in patients who have not responded to SSRIs.
What is biological treatment?
A type of treatment that uses substances made from living organisms to treat disease. These substances may occur naturally in the body or may be made in the laboratory. In cancer, some biological therapies stimulate or suppress the immune system to help the body fight cancer.
Is CBT a biological treatment?
The results are breathtaking—very clear and significant changes were noted pre- and post-CBT in blood flow to the brain clearly revealing that CBT is a potent biological intervention.
Which biological treatment is often used to treat severe depression?
Selective serotonin reuptake inhibitors (SSRIs) SSRIs increase the amount of serotonin in the brain. Researchers aren't exactly sure why an increase in serotonin helps relieve depression, but decades' worth of studies suggest these medications help improve mood.
What are the top 3 antidepressants?
Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed type of antidepressant and include: Fluoxetine. Citalopram. Sertraline.
Is citalopram a first line antidepressant?
Sertraline and citalopram may be considered as second line agents by specialists with caution.
What is the first line of antidepressants?
In general, because of the side effect and safety profile, selective serotonin reuptake inhibitors (SSRIs) are considered to be the first line antidepressants. Other preferred options include tricyclic antidepressants, mirtazapine, bupropion, and venlafaxine.
What is the management of depression?
Management of depression involves comprehensive assessment and proper establishment of diagnosis. The assessment must be based on detailed history, physical examination and mental state examinations. History must be obtained from all sources, especially the family.
Why is ECT used in continuation phase?
There are evidences to support the use of specific psychotherapy in continuation phase to prevent relapse. The use of other somatic modalities (e.g. ECT) may be useful in patients where pharmacology and/or psychotherapy have failed to maintain stability in continuation phase.
What is maintenance phase treatment?
The goal of maintenance phase treatment is to prevent recurrence of depressive episodes. On an average, 50-85% of patients with a single episode of major depression have at least one more episodes. Therefore, maintenance phase treatment may be considered to prevent recurrence.
What are the determinants of psychotherapy?
The major determinants of type of psychotherapy are patient preference and the availability of clinicians with appropriate training and expertise in specific psychotherapeutic approaches. Other clinical factors which will influence the type of psychotherapy include the severity of the depression.
What happens if a patient relapses after discontinuing medication?
If a patient suffers a relapse upon discontinuation of medication, treatments need to be promptly reinitiated. In general, the previous treatment regimen to which the patient responded in the acute and continuation phase are to be considered. MANAGEMENT OF TREATMENT RESISTANCE DEPRESSION.
What is the goal of acute phase treatment?
The goal of acute phase treatment is to achieve remission, as presence of residual symptoms increase the risk of chronic depression, poor quality of life and also impairs recovery from physical illness. Treatment generally results in improvement in quality of life and better functional capacity.
What did scientists think about psychedelics in the 1950s?
In the 1950s, shady US government scientists thought that psychedelic-induced ego-obliteration would make people more vulnerable to suggestion, and therefore, change (yes, MK Ultra, 10 history points to you).
What does hallucinogen do?
Like SSRI’s, hallucinogens work through serotonin, albeit they more specifically target the magical serotonin 2A receptor.
Is ketamine a SSRI?
Way more exciting than SSRI’s is the use of the club-drug, ketamine, aka “special K”. Ketamine’s great, offering feelings of sedation, pain relief, and memory changes, the three key elements to a great night at a David Guetta concert. It also increases blood pressure, can be addictive, lethal, and maybe more frighteningly, can transport users into a terrifying hallucination-trance-state referred to as the “K-hole”. Yikes.
Is emotion a product of the central nervous system?
At one time, scientists used to think that brain lesion studies and deep brain stimulation and optogenetics and fMRI and EEG and intracerebral pharmacological interventions supported the idea that emotion was the product of the central nervous system – the brain . How naive. Anyway, to the evidence.
Is SSRI better than placebo?
Another major review from roughly the same period (Cipriani, 2018) indicated that all antidepressants, including SSRI’s, offer modest short-term benefits to patients with MDD and are more effective than a placebo for its treatment. It looks like the scientific jury is still out on this one.
How many people are affected by depression?
Depression is the most prevalent psychiatric disorder, which affects more than 300 million individuals [ 2 ]. It is an incapacitating disorder, responsible for most of the 800,000 annual suicides [ 2 ]. Along with population growth and aging, the number of individuals with depression has also increased considerably and led to overloaded healthcare ...
What is a CPG in medicine?
Clinical practice guidelines (CPGs) for treatment of depression, founded on scientific evidence, are essential to improve patient care. However, economic and sociocultural factors may influence CPG elaboration, potentially leading to divergences in their recommendations.
Is pharmacological treatment for depression considered a strategy?
First, it should be noted that pharmacological treatment of depression is one of the strategies that should be considered to ensure adequate patient care. Pharmacotherapy should be prescribed only after a careful evaluation of the patient, including risk of suicide, requirement of hospitalization, indication of psychotherapy, and existence of comorbidities among other clinical and psychosocial aspects.
Is SSRI a first line treatment?
All CPGs considered SSRIs as a first-line antidepressant treatment . However, we identified two important discrepancies. Besides SSRIS, as options, the CANMAT CPG recommended the use of agomelatine, milnacipran, and mianserin [ 25 ]; and the Colombian CPG recommended the use of amitriptyline [ 22] as first-line treatment based on pharmacoeconomic studies.
What is the best treatment for depression?
Good options for treatment for depression include drug therapy, psychotherapy such as cognitive behavioral therapy (CBT), or a combination of the two.
How do SSRIs help with depression?
SSRIs increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerve cells. They are often selected as a first-line drug treatment for depression due to effectiveness and a lower risk of side effects compared to older antidepressants. Most SSRIs are now available in generic form, making them very affordable.
What is Zulresso injection?
Zulresso ( brexanolone) injection from Sage Therapeutics was approved in March 2019 for the treatment of Postpartum Depression (PPD) in adult women. PPD is a major depressive episode that occurs following childbirth or during pregnancy with symptoms of sadness, loss of interest, inability to feel pleasure, and lack of self-worth. Postpartum depression can also interfere with the maternal-infant bond or lead to suicidality.
What is MAO inhibitor?
Monoamine oxidase inhibitors (MAOIs) work by irreversibly blocking the enzyme monoamine oxidase (both MAO-A and MAO-B when used for depression), and preventing the breaking down of neurotransmitters such as serotonin, norepinephrine, and dopamine. Typically used as a third or fourth line treatment due to severe side effects, diet restrictions, and the possibility of serotonin syndrome. Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressant to be developed.
Which TCAs block serotonin?
The tertiary amine TCAs have a greater effect at blocking serotonin (compared to norepinephrine) and include: amitriptyline, clomipramine, doxepin, imipramine, and trimipramine. The secondary amine TCAs preferentially block norepinephrine and include: desipramine, nortriptyline, and protriptyline.
How many people respond to antidepressants?
No single antidepressant medication has been found to be the best treatment for every patient. In general 40% to 60% of patients (4-6 out of 10 patients) will have a positive response to the first antidepressant medication they try.
How long does it take for a person to feel the effects of a drug?
Drug therapy used in treatment involves medications that alter the chemical messengers (neurotransmitters) in the brain. It generally takes four to eight weeks for most patients to feel the full effects of antidepressant medications.