Depression Resources - Help And Information home page
refer a friend
bookmark us
contact us
privacy policy
terms of use
sitemap
 
   
Depression Website Directory Home
Help And Resources
Depression In The News
Depression Related Products
Depression Items At Auction
Refer A Friend
Contact Us
Terms Of Use
Privacy Policy
Bookmark Us

Depression Resources Depression
Depression Information
Depression News
Online Depression Help
Depression Symptoms
Depression Services
Depression Books
Depression Talk
Depression Causes
Depression Medication
Depression Doctors

Depression Help And Information
Depression Among College Students - An Essay
Graduation time rolls around, and you already know where you will end up next year for college. You...

What Depression Really Means
Is it the blues, sadness, or depression? Here are some tips and tools to tell the difference, and th...

Depression Diagnosis
Proper diagnosis of depression or any other illness is the key to effective treatment and cure. So, ...

Antidepressants 101- What You Absolutely Need to Know
Change in social and economical states throughout the world although has brought prosperity among th...

It Aint Easy Being Brave
Many people think being brave means having no fear, but courage is actually continuing on, in spite ...

FDA Approves Vagus Nerve Stimulation as a Treatment for Depression
Today, July 15, 2005, the U.S. Food and Drug Administration(FDA) approved vagus nerve stimulation as...

A Simple Cure For Anxiety And Depression
Although anxiety and depression cost billions of dollars to heal, the cure is actually quick and fre...

Chronic Depression: Disease or Charcter Flaw?
On June 15th, 2004, the FDA Medical Devices Panel recommended approval of the vagus nerve stimulator...

Anticipatory Grief and Holidays: 12 Survival Tips
Holidays are something else to worry about for those who are experiencing anticipatory grief. You m...

Depressed? Wise Woman Ways Offer a Helping Hand
Winter time is depression time for many women. Perhaps it is harder to look at the bright side when ...


Depression Quick Facts Several recent clinical studies are showing more and more illnesses are related to depression, including: osteoporosis, diabetes, heart disease, some forms of cancer, eye disease and back pain.



XML Sitemap Generator
If you are not interested in paper samples , then you have already missed a lot.
  Depression Series (Part 2): My Antidepressant Doesn’t Work - What Can My Psychiatrist Do?

Victory For The Silent Victim
A Survival Guide for Those Whose Loved One Suffers from Depression or Anxiety.

Author: Michael Rayel

Article source: http://outspokenaustralia.blogspot.com/. Used with author's permission.

Maria has been increasingly depressed for the past few years. She has tried at least four newer antidepressants but so far, she doesn’t seem to respond. Unable to work, she’s now feeling helpless and hopeless. Likewise, her family is discouraged. Frustrated and baffled by Maria’s lack of progress, the family doctor refers her to a psychiatrist.

What can the psychiatrist do to help Maria?

The psychiatrist has several options in dealing with a treatment-resistant or refractory depression. First, Maria’s psychiatrist can optimize the dose of her antidepressant. Maria has been taking low doses of antidepressants. In spite of her lack of response, the medication dosage has not been increased. To obtain a clinical response, her psychiatrist should increase the dose every two to three weeks. The antidepressant can be adjusted up to the maximum allowable dose if no or only partial response is observed.

Second, her psychiatrist can choose to augment the effect of her antidepressant with another medication such as lithium, triiodothyronine (T3), or buspirone. Among augmenters, lithium and triiodothyronine have the best support from the literature. Despite lithium’s efficacy, some doctors avoid this drug because it requires regular blood monitoring and has unfavorable side effect profile such as acne, tremors, and thyroid and renal dysfunction.

Recently, studies have shown atypical neuroleptics such as olanzapine and risperidone to be good augmenters. In my opinion, further studies are necessary to establish these two drugs as standard augmenter. Indeed, research studies and clinical experience have found augmentation strategy to be effective.

Third, combination strategy is worthwhile to try. Maria’s psychiatrist can add another antidepressant to boost the effect of her current antidepressant. For instance, trazodone can be added to an SSRI (serotonin reuptake inhibitor e.g. citalopram). Literature suggests that combining two drugs with different mechanisms of action and drugs that involve several brain chemicals has resulted in clinical improvement. In this scenario, one antidepressant plus another antidepressant is equal to three, or four or even ten, not two.

Fourth, the psychiatrist can switch from one antidepressant to another. Previous studies have shown that when making a switch, a drug should be replaced by a drug from a different class e.g. from SSRI to SNRI (serotonin and norepinephrine reuptake inhibitor e.g. venlafaxine), or from TCA (tricyclic agent e.g. nortriptyline) to SSRI. But recent studies show that switching drugs within the same class (e.g. SSRI to another SSRI) is just as effective.

Fifth, Maria’s psychiatrist can also treat other ongoing symptoms or drug-related problems that further complicate her depression. If she is anxious and agitated, then her psychiatrist should prescribe antianxiety drug (e.g. lorazepam) or if Maria is psychotic then adding an antipsychotic drug should help. Moreover, medication side effects (such as insomnia, dryness of mouth, constipation, etc.) that negatively affect Maria’s compliance to the drug should be addressed promptly.

Lastly, if despite above measures Maria doesn’t respond to antidepressants, then electroconvulsive therapy should be entertained. Of course, this procedure should be done with her consent.

In summary, Maria’s psychiatrist can optimize the dose, augment or combine treatment, switch the medication, treat side effects and ongoing symptoms, or use electroconvulsive therapy for treatment-resistant or refractory depression.

About The Author

Copyright © 2003. All rights reserved. Dr. Michael G. Rayel " author (First Aid to Mental Illness"Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as a first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

mike@drrayel.com




  Print this page
                      



Google Center
NYC Airports Limo provides the 5 star Pennsylvania Limousine, Car and Airport Shuttle service that ensures your transport needs are taken care of in a professional, timely and cost effective manner. NYCAirportsLimo offers Car Service in PA and Pennsylvania Limo Service PA to NYC, JFK, Manhattan, New York, EWR, LaGuardia, LGA, Newark Airport and Limousine Service in Pennsylvania for any occasion that can be scheduled to meet your needs over the duration or your event or stay in PA or take advantage of our Car service PA for safe and high quality vehicles at the best market rates.
CT Airlink is the affordable and cheapest Limousine and Car Service in Westchester to NYC, Brooklyn, Brooklyn, Queens, JFK, LaGuardia - LGA, Newark Liberty - EWR, Hartford Bradley - BDL and BOS - Boston Logan Airport. CTairlink use shuttles for White Plains Limo Service, White Plains Airport Car Service and White Plains Limousine Service . Travel in comfort and at your leisure with CT Airlink Limousine & Car Service for top quality private transportation and exceptional customer service. We operate Sedans, SUVs & Luxury vans for NY Limousine, NY Airport Shuttle and NY Car Services.
Benefit from fantastic savings on acim , just by taking a look at http://acourseinmiraclesnow.com
In case you're interested in knowing more info on bravo yogurt, stop by thetruthaboutcancerstore.com
walk in std clinic near me
Progentra Male Enhancement Pills Review
elektronik sigara
elektronik sigara
Visit www.healthymensinfo.com/tengenix-review-is-tengenix-worth-your-time/ to find out more regarding TenGenix

  Additional Resources
New Article Notifcation


Exchange Links With Us
Add Your Resource Here.



No charges for webcam suicide audience 29 May 2007 18:16, Yahoo News
... the suicide of Kevin Whitrick, 42, from Wellington, Shropshire. Mr Whitrick had suffered from depression following a serious car accident which he had not recovered from. In a statement, ...

People in the greatest need of cardiac medications and interventions are less likely than moderately ill patients to get the full range of heart drugs and procedures, a pair of cardiologists suggests. ... in Edmonton. He wasreferring to patients whose functional capacity is limited or who have depression. The second study looked at rates of catheterization of heart patients over two periods ...



Copyright © BestDepressionResources.com 2006 - 2014 All Rights Reserved    Site Powered by Websites-r-us.info