Treatment of choice for acute depression is?
Ans. is 'a' i.e., SSRIs Treatment modalities for depression1) Drugs: - The treatment of major depression usually requires starting pharmacotherapy with antidepressants.Antidepressants are: -A. Tricyclic antidepressants (TCAs):- Imipramine, Amitriptyline, Trimipramine, Clomipramine, Desipramine, Nortriptyline, Amoxapine, Reboxetine.B. SSRI (selective serotonin reuptake inhibitors): - Fluoxetine, Paroxetine, sertaline, Citalopram, Escitalopram. These drugs devoid of side effects seen with TCAs and are safe in elderly.C. Atypical antidepressants Trazodone, Mianserine, Mitrazapine, Venlafaxine, Duloxetine, Tianeptine, Amineptine, Bupropion.2) ECT (Electroconvulsive therapy):- Indications of ECT in depression are : - i) Suicidal risk ii) Depression with psychotic feature iii) Resistant depression iv) Severe agitated or stuporous depression with lack of self care.3) Psychotherapy: - Supportive psychotherapy, cognitive behavioral psychotherapy.Choice of Antidepressants* There is no ideal antidepressant. First choice is determined by side effect profile least objectionable to patient's physical status, severity of disorder including self harm, patient preference & nature of any associated illness.* Since SSRIs are comparatively free of side effects and are not costly, they are generally recommended as first choice antidepressants. Where there is a previous history of response to a specific drug or class, the best first choice is that antidepressant.
SSRIs
Alprazolam
ECT
Psychotherapy
Mood Disorders