If we prescribe an antidepressant, what dose do we start and how do we increase it? A slower antidepressant up-titration may reduce side effects and improve initial adherence, but it may also delay clinical response
How do you individualize antidepressant prescribing? (Part 2) Read More »
Understanding the patient’s prior experiences with psychotropic medications allows you to individualize your prescribing – pick the right medication, the right starting dose, and the right titration for this person.
How do you individualize antidepressant prescribing? (Part 1) Read More »
Adding low-dose aripiprazole (2-5mg) to a partially-effective antidepressant is an effective depression augmentation strategy for adults and older adults.
How do you use low-dose aripiprazole for depression augmentation? Read More »
Data to support the Mediterranean diet as a treatment for depression is currently lacking. Exercise may prevent depression and improve depressive symptoms.
Can dietary interventions or exercise treat depression? Read More »
Adding bupropion to an SSRI/SNRI is not an effective augmentation strategy for major depression.
Is adding bupropion to an SSRI/SNRI an effective depression augmentation strategy? Read More »
Special Guest Author Keith Sakata, MD
Need maximum pain relief? TCAs work best. In general, choose nortriptyline over amitriptyline—it’s less sedating, less anticholinergic, and less likely to cause weight gain.
What medications can help both pain and depression? Read More »
Bupropion is associated with a dose-dependent risk of seizures that is highest at the time of peak plasma concentrations.
The rate of seizures from bupropion XL 300mg is no higher than from SSRIs.
Does this patient’s history of binging and purging make it unsafe to start bupropion? Read More »
Treatment for depression during pregnancy is available: ACOG recommends psychotherapy and the continuation of antidepressants in women who have recurrent and/or severe depression.
How do you counsel patients about taking medications for depression during pregnancy? Read More »
An adequate trial of an antidepressant for the acute treatment of major depressive disorder requires adequate adherence (80% of doses) to an adequate dose (moderate dose of an SSRI or mirtazapine, FDA max dose for venlafaxine) for an adequate duration (4-8 weeks).
When should you stop an SSRI trial for depression due to lack of efficacy? Read More »
A patient’s perception of the balance between efficacy and side effect burden is generally more important than the objective severity of a particular side effect.
How do you manage the side effects of SSRIs? Read More »
