Depression in elderly is treated with?
Ans. c. Fluoxetine. (Ref. Psychiatry by Niraj Ahuja, 5th ed., 78)Newer anti-depressants like SSRI (fluxetine, sertraline, citalopram, mitrazepam, and venlafexine) have very little cholinergic effects, side effects and hence safer drugs to use in elderly, especially with heart diseases and BMP. Educational points: Grief "Bereavement"Depression "Pathological Grief"Definition- Sadness & Tearfullness- |sleep, Appetite & Interest- Sadness& Tearfulness- |sleep, Appetite & InterestSymptoms- Wax & Wane- Shame & guilt less common- Threaten suicide less often- Symptoms can last < one year- Usually return to baseline level of Functioning within 2 months- Pervasive & Unremitting- Shame & guilt are common- Threaten suicide more often- Symptoms continue > one year- Patients do not return to baseline level of functioningTreatmentSupportive PsychotherapyAntidepressant (5SRI) Post partum Blues"Baby Blues"Post partumDepressionPostpartumPsychosisOccur afterAny babyThe 2nd babyThe 1st babyBegins after birthUp to 2 weeksWithin 1 monthWilthin 1 monthThoughts of hurting the babyNo. Mother cares about the babyYesYesSymptomsMild depressionSevere DepressionSevere Depression & Psychotic symptomsTreatmentNo Treatment necessaryAntidepressantsAntidepressants & Mood Stabilizers or Antipsychotics
Imipramine
Dothiepin
Fluoxetine
Mianserine
Mood Disorders