Antidepressants

Treatment with antidepressants is often used to address the following issues:

• Depressed, sad or irritable mood
• Aches and pains
• Problems with sleep or appetite
• Fatigue or tiredness
• Difficulty concentrating or remembering
• Loss of interest in activities that previously brought pleasure
• A feeling of nervousness or tension
• Anxiety attacks

The severity of the disease lies in the fact that it is very widespread and can lead to disability. There are various treatments that reduce the duration of the depression.

Depression often occurs on the background of the various stresses of life – change of residence, problems in family and marital life, problems at work, and others. It may be associated with medical problems or the presence of chronic physical disease, especially accompanied by severe pain.

Life stress and health problems can lead to imbalances in the exchange of neurotransmitters in the nervous system. The results of this chemical imbalance are the frequently observed in depression symptoms such as disturbed sleep or appetite, fatigue, difficulty concentrating, and chronic pain. Drugs, antidepressants restore the normal balance of chemicals, which eliminates some of these symptoms.

• When counseling patients with depression who are receiving pharmacotherapeutic interventions, the patient should be informed that adverse effects might occur immediately, while resolution of symptoms may take 2 to 4 weeks.
• Wh evaluating a patient for the presence of depression, it is essential to rule out medical causes of depression and drug-induced depression.
• The goal of pharmacological treatment of depression is the resolution of current symptoms and the prevention of further episodes of depression.
• When determining if a patient has been nonresponsive to a particular pharmacotherapeutic intervention, it must be determined whether the patient has received an adequate dose for an adequate duration. If tricyclic antidepressants are being used, a serum level may be useful, especially in special populations such as the elderly, and those with concurrent medications that may alter the pharmacokinetic profile of the TCAs.
• Childhood depression occurs commonly and can present with nonspecific symptoms. The dosage range, titration, and adverse effects of fluoxetine, imipramine, and sertra-line are similar in children and adults.
• An assessment of compliance should be made with every patient interaction. Remember that accurate capsule or tablet counts do not mean the patient has consumed the medication or consumed it in the manner prescribed.
• If a patient exhibits a partial response to a pharmacotherapeutic agent, augmentation therapy should be considered before the trial is abandoned and the patient is treated with an alternative therapeutic agent.
• When evaluating response to an antidepressant agent, in addition to target signs and symptoms, consider quality-of-life issues such as role, social functioning, and occupational function. In addition, the tolerability of the agent should be assessed because the occurrence of side effects may lead to nonadherence to the regimen.