PSYC 3230 Lecture Notes - Lecture 18: Psychoeducation, Transcranial Magnetic Stimulation, Cognitive Behavioral Therapy
26 Mar 2018
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Severe and chronic major depression (high suicidality, extremely low motivation) Unipolar depression = antidepressants (ssris, tricyclics, maos, mixed reuptake inhibitors) Ssris most commonly prescribed because fewer side effects and nonlethal. Very few differences in effectiveness depending on the antidepressant chosen often have to (cid:862)shop a(cid:396)ou(cid:374)d(cid:863) to fi(cid:374)d o(cid:374)e that (cid:449)o(cid:396)ks. Only ~50% of patients benefit beyond placebo (no clear advantage for mild-to- moderate depression. Only ~25% achieve normal functioning with medication alone. But not without side effects (tremors), so often prescribed another drug to manage ses. 70% relapse within 5 years of starting lithium even when compliant. Ne(cid:449) d(cid:396)ug (cid:862)valp(cid:396)oate(cid:863) e(cid:395)uall(cid:455) effecti(cid:448)e but 2. 7(cid:454) highe(cid:396) (cid:396)ate of co(cid:373)pleted suicides tha(cid:374) Antidepressants can induce mania in some (even those without preexisting bipolar disorder) Much safer than in the past (bone breakage from seizures) Only for medication non-responders (50% will benefit from ect but will relapse without supplemental treatment)
