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Clinical News & Knowledge: Depression
New Algorithms for the Management of Treatment-Resistant Bipolar Depression
Current guidelines for the management of bipolar depression are outdated because they are based on the definition and treatment of unipolar depression, according to Eduard Vieta, MD, PhD, director of the bipolar disorders program at the University Clinic Hospital of Barcelona, Spain. Dr Vieta led a study to create new definitions and algorithms for the management of treatment-resistant bipolar I and bipolar II depression. More »
Depression During Pregnancy
Major depressive disorder (MDD) is common during childbearing. Depression that interferes with function develops in an estimated 14.5% of pregnant women.1 In a recent population-based study, Munk-Olsen and colleagues2 determined the prevalence of psychiatric disorders relative to childbearing. The overall risk for any psychiatric episode after delivery was elevated for women during the first 3 postpartum months. However, the increased risk specifically for major depression remained elevated for... More »
The Role of Antidepressants for the Treatment of Bipolar Depression
Although rapid-cycling bipolar disorder has been linked to the use of antidepressants, these treatments may still have a role in the management of patients with bipolar depression, said Stephen V. Sobel, MD, clinical instructor at the University of California, San Diego School of Medicine, in a presentation at the U.S. Psychiatric and Mental Health Congress in Las Vegas. More »
rTMS May Be Effective in Patients With Treatment-Resistant Bipolar Depression
Repetitive transcranial magnetic stimulation (rTMS) may be an effective therapy for treatment-resistant bipolar depression, according to the results of a recent pilot study led by Guohua Xia, MD, PhD, assistant clinical professor of psychiatry at the University of California, Davis. More »
Continuation Treatment and Relapse Prevention in Pediatric Depression
The prevalence of depression in children and adolescents ranges from 2% to 8% in the general population, which indicates that depression in this population is a major public health concern.1-3 This is especially apparent when rates of depression are compared with other serious medical conditions in childhood, such as diabetes, which has a prevalence of 0.18%.4 The burden of depressive illness—including significant functional impairment in interpersonal relationships, school, and work—on the... More »
Atypical Antipsychotics for Treating Major Depression
Major depressive disorder (MDD) does not always respond to antidepressants. Whether we are using SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclics, monoamine oxidase inhibitors, or heterocyclics (trazodone, nefazodone, bupropion), the result often falls short of full remission of symptoms. More »
Lamotrigine in Acute Bipolar Depression: Two Thumbs Up—or One?
I just read and enjoyed “Treatment-Resistant Bipolar Disorder”1 at www.PsychiatricTimes.com, and wanted to thank the author for pulling together a great deal of useful information in a succinct and lucid format. More »
National Academy Urges Changes in Screening and Treatment of Depression
A National Academy of Sciences (NAS) report urging a more coordinated approach to prevention and treatment of depression in parents—because of its impact on children—hit the streets just as Congress began considering legislation to reform the US health insurance system. The NAS report made a number of recommendations for changing the approach of both public and private health insurers toward depression, although the front-line troops expected to deal with the problem are primary care physicians,... More »
Combination therapy improves both pain and depression
For patients who have comorbid depression and musculoskeletal pain, optimized antidepressant therapy combined with pain self-management may result in substantial improvements in both conditions. However, additional interventions may be needed to achieve bigger improvements in pain and higher depression response and remission rates. More »
Treatment-Resistant Depression
Approximately 32 to 35 million adults in the United States have an episode of major depression sometime during their lifetime, and many of them do not respond to initial treatment.1 The results of an analysis undertaken by Fava and Davidson2 suggest that between 29% and 46% of depressed patients fail to respond fully to antidepressant treatment of adequate dose and duration; about 15% of patients fail to respond to multiple treatment trials.3 Fagiolini and Kupfer4 have suggested that patients... More »
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