Rational drug use in the treatment of depression

Research output: Contribution to journalReview article

40 Citations (Scopus)

Abstract

New drugs are being developed for the management of depression in response to the growing awareness of the prevalence and disability associated with the disorder and the need for agents with improved side effect profiles. All antidepressants are equally effective for treating uncomplicated unipolar depression without psychotic features. For patients with atypical depression with prominent anxiety, agitation, sleep loss, and irritability, monoamine oxidase inhibitors are the first choice. Data are accumulating supporting the efficacy of selective serotonin reuptake inhibitors (SSRIs) in these depressive subtypes. Factors to consider when choosing an antidepressant include spectrum of adverse effects, long-term tolerability, dosing schedule, clinically significant drug interactions, underlying medical conditions, earlier response to therapy, and pharmacoeconomics. Based on these criteria, it is suggested that a trial with the SSRIs be attempted first. Venlafaxine and nefazodone are newer agents with mechanisms of action that have advantages over tricyclic antidepressants and monoamine oxidase inhibitors. Choosing a drug that is effective, tolerable, and convenient will improve the likelihood of achieving and maintaining a full remission. It will also decrease the morbidity and mortality of this very treatable disease.

Original languageEnglish
Pages (from-to)45-61
Number of pages17
JournalPharmacotherapy
Volume17
Issue number1
StatePublished - 1 Jan 1997

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Monoamine Oxidase Inhibitors
Serotonin Uptake Inhibitors
Antidepressive Agents
Depression
Pharmaceutical Economics
Tricyclic Antidepressive Agents
Depressive Disorder
Drug Interactions
Pharmaceutical Preparations
Appointments and Schedules
Sleep
Anxiety
Morbidity
Mortality
Therapeutics
nefazodone
Venlafaxine Hydrochloride
Long Term Adverse Effects

Cite this

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Rational drug use in the treatment of depression. / Cohen, Lawrence J.

In: Pharmacotherapy, Vol. 17, No. 1, 01.01.1997, p. 45-61.

Research output: Contribution to journalReview article

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