Pharmacological treatment of depression. Consulting with Dr Oscar
Can Fam Physician. 1999 Nov:45:2663-8.
Author
M J Berber 1
Affiliation
●1Markham Stouffville Hospital, Ontario. markberber@attcanada.net
●
PMID:
10587774
●
PMCID:
PMC2328680
Abstract
Objective:
To review the pharmacological treatment of depression and to evaluate current strategies for treatment to maximize the benefits of antidepressant medications.
Quality of evidence:
MEDLINE was searched to January 1999, using the headings depression, combination, augmentation, lithium, triiodothyronine, pindolol, buspirone, methylphenidate, and electroconvulsive therapy, for randomized controlled trials, systematic overviews, and consensus reports. Recent high-quality reviews were often found. References from papers retrieved were scrutinized for other relevant reports. Preference was given to more recent articles and well-designed studies. Recommendations from academic groups were analyzed.
Main message:
Optimization of antidepressant therapy is the cornerstone of pharmacological treatment of depression. When symptoms persist despite optimization, further strategies include substitution, combination, augmentation, and reviewing and sometimes referring. Decisions are based on the evidence supporting the various strategies.
Conclusions:
Antidepressants will work only if prescribed correctly. Awareness of the strategies for using antidepressants and evaluating their effectiveness improves primary care physicians' ability to treat this common disorder.
Publication types
●
Review
MeSH terms
●
Antidepressive Agents / administration & dosage*
●
Antidepressive Agents / adverse effects
●
Depressive Disorder / diagnosis
●
Depressive Disorder / drug therapy*
●
Depressive Disorder / psychology
●
Drug Therapy, Combination
●
Humans
●
Randomized Controlled Trials as Topic
●
Referral and Consultation
●
Treatment Outcome
Substances
●
Antidepressive Agents