A 72 year old lady is severely depressed. For the past 2 days she has suicidal thoughts with an actual intent to die. Which of the following is best suitable to allete the symptoms?
ECT is the most effective (about 70-85%) treatment of severe depression--paicularly the delusions and agitation commonly seen with depression in the elderly. It is indicated when medical conditions preclude the use of antidepressants, nonresponsiveness to these medications, and extreme suicidality. ECT in severe depression show that it is more effective than pharmacotherapy. It is also effective in the manic disorders and psychoses during pregnancy (when medications may be contraindicated). It has not been shown to be helpful in chronic schizophrenic disorders, and it is generally not used in acute schizophrenic episodes unless medications are not effective and it is urgent that the psychosis be controlled (eg, a catatonic stupor complicating an acute medical condition). Ref: Eisendrath S.J., Lichtmacher J.E. (2013). Chapter 25. Psychiatric Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014.
Selegiline
Amitriptyline
Haloperidol + Chlorpromazine
ECT