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Outpatient Management of Depression
13 - Index |
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Index
Note: Page numbers in italics indicate figures;
page numbers followed by t indicate tables.
Acetaminophen, 91t
Activity level, 13
in different types of affective disorders,
16t
Acute therapeutic index, 105,
106t-114t, 115
Adolescents with depression
antidepressant dosage for, 130t-131t
irritability in, 14t
suicide in, 21
Affect of patient
in diagnosis of depression, 34t
in different types of disorders, 16t
Age
at depression onset
atypical, 15
melancholic, 15,
24
suicide risk and, 40,
40t
Alcohol intake
antidepressant drug therapy and, 84
biochemical effects of, 23,
46
as cause of depression, 17,
33
gender differences in, 25-26
self-medication with, 21
suicide risk and, 40t
TATCA with, 116
Alfentanil, 91t
Alpha-1–adrenergic receptor blockers
dizziness from, 195-196
sexual dysfunction and, 119
TATCA effect on, 116
tolerability of, 107t
Alprazolam, 92t
Alprenolol, 91t
Amiodarone, 91t
Amitriptyline (Elavil)
action mechanisms of, 58t-59t,
62t-64t, 80
action sites of, 80,
81
cost of, 126t
Amitriptyline (continued)
CYP enzymes and, 90t-91t
dosage of, 130t,
132t-133t
drug interaction with, 184-186
effectiveness of, 83
frequency of prescriptions for, 138t
pharmacology of, 82-83
STEPS criteria for, 107t
Amoxapine (Ascendin)
action mechanisms of, 58t-59t
dosage of, 130t,
132t-133t
STEPS criteria for, 107t
Anafranil. See Clomipramine.
Analgesics, 91t
Androstenedione, 92t
Anorexia, 194
Antiarrhythmics
CYP enzymes and, 91t
TATCA effect on, 116
Anticonvulsants, 91t
Antidepressant drug therapy. See also specific drug or
drug type.
action mechanisms of, 58t-59t,
62t-64t
action sites of, 66t-67t
addiction potential of, 51
adverse effects of, 68t-76t,
78t-79t
alternative monodrug therapy in, 205-206
antipsychotics with, 208
anxiolytics with, 207-208
assessing progress in, 174,
175
augmentation strategies in, 202-205
clinical trials in, 52
cost of, 51,
124-125, 126t-129t
CYP enzymes and. See Cytochrome P450 enzymes,
drug interactions with.
dosage of, 130t-133t
adjustments in, 201
drug combinations in, 121-122,
206-207
drug interactions in, 62t-64t,
66t-67t, 84,
116-117, 169-170,
179-191
drug selection in, 137,
138t, 139
duration of, 53-54,
177-178
Antidepressant drug therapy (continued)
effectiveness of, 17,
119-120
acute, 120-121
drug combinations in, 121-122
lag time before, 44-46
maintenance, 123
potency in, 81,
85
prophylactic, 123-124
response rate in, 121-122
spectrum of, 122
electroconvulsive therapy with, 209
failure of, 205-207
follow-up visits in, 172-174
four “D’s” of, 40-51,
54
goals in, 57
half-lives in, 89,
95, 99-100
Hamilton Depression Rating Scale in, 33t
indications for, 49-50
initiation of, 171
lithium with, 18,
36, 208-209
long-term health consequences of, 51
maintenance therapy in, 178
mood stabilizers with, 208-209
noncompliance with, 54-55,
55t
other medications with, 179,
180t, 181-184,
182t
partial response in, 200-205
pharmacodynamics of, 65-84
pharmacokinetics of, 89,
117-118
placebo response vs, 53t,
53-54
rational drug development in, 59-60
relationship among pharmacodynamics, pharmacokinet-
ics, and interindividual variability in,
61, 65
response vs remission with, 52,
53t
safety in
acute therapeutic index in, 105-106,
106t-114t, 115
long term, 115-116
simplicity of, 125-135
STEPS criteria of, 50
therapeutic trial of, 26
tolerability in, 118-119
Antidepressant drug therapy (continued)
treatment of adverse effects in. See also specific drugs or
drug types.
anorexia, 194-195
confusion, 195
constipation,
195
diaphoresis, 195
diarrhea, 195
dizziness, 195-196
drowsiness, 196-197
drug or dose adjustment in, 194
dry mouth, 197
fatigue, 197-198
hyperphagia, 198
insomnia, 198
nausea, 198-199
nervousness, 199
sexual dysfunction, 199
vision disturbance, 199
in treatment-refractory patients, 26
withdrawal from, 100t-101t,
100-103
Zung Depression Self-Report Rating Scale
in, 176-177, 177
Antiestrogens, 92t
Antihistamines, 92t
Antihypertensive drugs, 17
TATCA effect on, 116
Antipsychotic drugs
antidepressants with, 208
CYP enzymes and, 90t-92t
Anxiety disorders, serotonin selective reuptake inhibitors
for, 135
Anxiolytics, antidepressants with, 207-208
Apathy, 13, 14t,
27
in different types of affective disorders,
16t
Aphrodyne (yohimbine), 83t,
199
Appetite changes, 13
in different types of affective disorders,
16t
Ascendin. See Amoxapine.
Astemizole, 92t
Attention. See Concentration/attention.
Atypical major depression
family history in, 15
onset age in, 15
signs and symptoms of, 16t
Aventyl. See Nortriptyline.
Barbiturates, 90t
Benzodiazepines, 90t, 92t
Benzphetamine, 92t
Benztropine, 83t
Bereavement, 15t
Beta-blockers, 90t-91t
Biochemistry of brain
alcohol intake and, 23,
46
in depression, 44
Bipolar disorder
family history of, 18
signs and symptoms of, 16t,
17-18
Briquet’s syndrome, 36
Bufuralol, 91t
Bupropion (Wellbutrin, Zyban)
action mechanism of, 58t-59t,
62t-63t
action site of, 80
advantages of, 164-165
adverse effects of, 72t-75t,
78t, 198
cost of, 129t
CYP enzymes and, 166
disadvantages of, 164-165
dosage of, 131t-132t
ascending, 135
drug interactions with, 166-167,
199
frequency of prescriptions for, 138t
half-life of, 95
indications for, 165,
167-168
potency of, 86
seizure risk with, 115,
165, 167
sexual dysfunction and, 119
STEPS criteria for, 113t,
164-165
to stop smoking, 165
Buspirone (Buspar)
as augmentation strategy, 204-205
for sexual dysfunction, 199
Caffeine, 90t
Calcium channel blockers, 92t
Cancer, 17, 182t,
204
Carbamazepine
antidepressant drugs with, 188-189
CYP enzymes and, 91t
Causes of depression, 17, 33
Celexa. See Citalopram.
Children with depression
antidepressant dosage for, 130t-131t
irritability in, 14t
weight changes in, 14t
Chlorpheniramine, 83t
Cholinergic rebound, 100, 100t
Cigarette smoking
bupropion for cessation of, 165
in depressed individuals, 23
Cimetidine, 83t
Cisapride, 92t
Citalopram (Celexa)
action mechanism of, 58t-59t
advantages of, 152
adverse effects of, 68t-71t,
76t
cost of, 127t
CYP enzymes and, 90t,
94t, 96t
dosage of, 82,
130t, 133t
starting, 124
frequency of prescriptions for, 138t
indications for, 148t
potency of, 85
STEPS criteria for, 109t
withdrawal from, 102
Clarithromycin, 92t
Classic major depression. See Melancholic depression.
Clomipramine (Anafranil)
action mechanism of, 58t-59t
CYP enzymes and, 90t-91t
dosage of, 130t,
132t-133t
efficacy of, acute, 121
STEPS criteria for, 107t
Clonazepam
antidepressants with, 207-208
CYP enzymes and, 92t
Clozapine, 90t, 92t
Cocaine, 17, 92t
Codeine, 91t
Communicating with patient
about and during antidepressant drug therapy,
47-50, 54-55,
55t, 172-173
educating about depression, 46
to initiate outpatient therapy, 43-48
typical patient questions about, 43t
psychosis assessment in, 42
questions to ask in diagnosis, 29,
32-33
suicide risk assessment in, 39-42,
40t
terminology for depressed mood in, 37t
Concentration/attention, 13,
14t
in different types of affective disorders,
16t
in workplace, 23
Confusion, 194-195
Constipation, 195
Cortisol, 92t
Cost of antidepressants, 124-125,
126t-129t
Counseling
medication with, 45
psychotherapy as, 45-46
Cyclosporine, 92t
Cyproheptadine (Periactin), 195,
199
Cytochrome P450 enzymes, drug interactions with, 80,
87, 107t-114t,
117, 150-151
dopamine and norepinephrine reuptake inhibitors,
166
mixed reuptake and neuroreceptor antagonists,
184-186
molindone, 187
norepinephrine selective reuptake inhibitors,
143, 145
oxidative drug metabolism and, 87-88,
90t-93t, 99t
serotonin and norepinephrine reuptake inhibitors,
153, 156
serotonin selective reuptake inhibitors,
147, 151-152,
185-186
serotonin 2A receptor blockade and weak
serotonin
reuptake inhibitors, 159-161
symptoms of, 183-184
testing for, 88-89,
96t-98t
Dapsone, 92t
Death. See also Suicide.
accidental, depression-related, 21
Debrisoquine, 91t
Dehydro-3-epiandrosterone, 92t
Desipramine (Norpramin)
action mechanism of, 58t-59t,
62t-63t, 83t
action site of, 80,
81
acute therapeutic index of, 106
adverse effects of, 198
cost of, 126t
CYP enzymes and, 91t
dosage of, 130t,
132t-133t
starting, 124
drug interactions with, 108t
frequency of prescriptions for, 138t
hypertension from, 115
sexual dysfunction and, 119
STEPS criteria for, 108t
N-Desmethylcitalopram, 91t
O-Desmethylvenlafaxine, 91t
Desyrel. See Trazodone.
Dexamethasone, 92t
Dextroamphetamine, 203-204
Dextromethorphan, 91t
Diabetes mellitus, 182t
Diagnosis of depression. See also Communicating with
patient.
algorithm for, 30-31
bipolar vs unipolar, 16t,
17-18
categories of, 12
critical variables in, 12t
differential, 17
DSM-IV criteria for, 13, 14t-15t
duration of symptoms in, 14t,
15t
family history in. See Family history.
laboratory tests in, 27,
30, 33,
37
medical conditions in, 14t,
15t, 27,
38
pathophysiology in, 17,
33
patient behavior in, 34t-35t,
36
patient self-descriptions in, 37t
in primary-care setting, 27-28
questions to ask patient in, 29,
32-33
signs and symptoms in, 13,
16t, 27-28
duration of, 298
steps in, 28-29,
30-31
Diagnostic and Statistical Manual IV (DSM-IV),
depression criteria in, 13,
14t-15t
Diaphoresis, 195
Diarrhea, 195
Diazepam, 90t, 92t
Diltiazem, 92t
Disopyramide, 91t
Dizziness, 195-196
Docetaxel, 92t
Dopamine, 17
Dopamine agonists, 203-204
Dopamine and norepinephrine reuptake inhibitors. See
also specific drugs.
action mechanism of, 58t-59t,
62t-63t
advantages of, 164-165
cost of, 129t
disadvantages of, 165-167
dosage of, 131t-132t
drug interactions with, 166-167
frequency of prescriptions for, 138t
seizure risk with, 165,
167
STEPS criteria for, 113t,
164-167
Dopamine uptake pump, 67t
Doxepin (Sinequan)
action mechanism of, 58t-59t
cost of, 126t
dosage of, 130t,
132t-133t
frequency of prescriptions for, 138t
STEPS criteria for, 107t
Drowsiness, 196-197
Dry mouth, 197
Effexor. See Venlafaxine.
Efficacy of drug therapy. See Antidepressant drug
therapy, efficacy of.
Elavil. See Amitriptyline.
Elderly population
antidepressant dosage for, 130t-131t
antidepressant drug therapy in, other medications
with,
179, 181,
182t
as risk group for depression, 17
Electroconvulsive therapy, 17,
209
Encainide, 91t
Energy, in different types of affective disorders, 16t
Epilepsy, 182t
Erex (yohimbine), 199
Erythromycin, 92t
Estradiol, 92t
Estrogen
CYP enzymes and, 92t
depression and, 25
Ethinylestradiol, 92t
Ethosuximide, 91t
Ethylmorphine, 91t
Family dysfunction, depression-related, 24,
35t. See also
Marriage.
Family history
in atypical major depression, 15
in classic major depression, 15,
24, 36
bipolar, 18,
36
unipolar, 22t
of suicide, 40
Fast Na+ channel blockade
drugs for, 62t-63t
physiological consequences of, 66t,
83
TATCA effect on, 116
Fatigue, 13, 14t,
27, 197-198
Felodipine, 92t
Financial problems, 28
Flecainide, 91t
Fluoxetine (Prozac)
action mechanism of, 58t-59t
adverse effects of, 68t-71t,
76t
cost of, 127t
CYP enzymes and, 91t,
94t, 96t,
115, 117,
150-151
dosage of, 82,
130t, 133t
starting, 124
drug interactions with, 150-152,
184-186, 188-189
frequency of prescriptions for, 137,
138t
half-life of, 99-100
indications for, 148t
potency of, 85
STEPS criteria for, 109t
withdrawal from, 102
FLUSH mnemonic, 101t
Fluvoxamine (Luvox)
adverse effects of, 68t-71t,
76t
cost of, 127t
CYP enzymes and, 94t,
96t, 117,
150
dosage of, 82,
131t-133t
starting, 124
drug interactions with, 150-151
narcotics, 189-191
frequency of prescriptions for, 138t
half-life of, 95
indications for, 148t
potency of, 85
STEPS criteria for, 109t
withdrawal from, 102,
150
Four “D’s” of antidepressants, 40-51,
54
Gender differences
in alcohol intake, 25-26
in suicide risk, 40t
Guilt feelings, 14t, 40,
43
Half-life, clinical importance of, 95,
99-100
Haloperidol, 91t
Hamilton Depression Rating Scale, 33t
Head carcinoma, 17
Headache, 27
Hepatic impairment, 130t-131t
Hexobarbital, 90t
Histamine-1 receptor blockade
drugs for, 62t-63t
physiologic consequences of, 67t,
107t, 195
TATCA effect on, 116
Hospitalization, 42-43
Human immunodeficiency virus infection, 180t
4-Hydroxyamphetamine, 91t
Hyperphagia, 198
Hypersomnia, 14t
Hypertensive crisis, 67t, 116-117
Hypomania, 16t, 18
Imipramine (Tofranil-PM)
action mechanism of, 58t-59t
adverse effects of, 72t-75t,
78t
cost of, 126t
CYP enzymes and, 90t-91t
Imipramine (continued)
dosage of, 130t,
132t-133t
efficacy of, 123
frequency of prescriptions for, 138t
indications for, 141-142
potency of, 86
STEPS criteria for, 107t
Immunosuppressants, 92t
Insomnia, 14t, 27,
198
Irritability, 14t, 27,
36
Laboratory testing, in diagnosis of depression, 27,
30, 33,
37
Lidocaine, 91t-92t
Lithium, antidepressants with, 18,
36, 203,
208-209
Loratadine, 92t
Lovastatin, 92t
Ludiomil. See Maprotiline.
Luvox. See Fluvoxamine.
Macrolide antibiotics, 92t
Manic episode, 18
Manic-depressive disorder
family history of, 18
signs and symptoms of, 16t,
17-18
Maprotiline (Ludiomil)
action mechanism of, 58t-59t
dosage of, 130t,
132t
hypertension from, 115
STEPS criteria for, 108t
Marriage
depression effect on, 24,
28
suicide risk and, 40t
Medical history, 27, 30,
33
Medical illness
with depression, 14t,
15t, 27,
38
suicide risk and, 40t
Medications, as cause of depression, 33
Melancholic depression
family history of, 15,
24
onset age in, 15,
24
signs and symptoms of, 13,
16t
Memory problems, 27
Menopause, 24-25
Mephenytoin, 90t
Mephobartibal, 90t
Methadone, 90t
Methylphenidate, 203-204
Metoprolol, 91t
Mexiletine, 91t
Mibefradil (Posicor), 88
Midazolam, 92t
Minodipine, 92t
Mirtazapine (Remeron)
action mechanism of, 58t-59t,
62t-64t, 77,
80, 161
advantages of, 162
adverse effects of, 72t-75t,
78t, 196-198
for anorexia, 195
cost of, 129t
disadvantages of, 163-164
dosage of, 131t-132t
ascending, 135
starting, 124,
134
efficacy of, acute, 121
frequency of prescriptions for, 138t
potency of, 86
sexual dysfunction and, 119
STEPS criteria for, 112t,
162-163
Mixed reuptake and neuroreceptor antagonists. See also
Monoamine oxidase inhibitors; Tertiary amine
tricyclic antidepressants.
action mechanism of, 58t-59t,
62t-63t
disadvantages of, 140-142
dosage of, 130t,
132t-133t
frequency of prescriptions for, 138t
history of, 139
indications for, 142-143
STEPS criteria for, 107t,
140-142
Molindone
CYP enzymes and, 91t
drug interactions with, 186
Monoamine oxidase inhibitors
action mechanism of, 59t,
63t
advantages of, 168-169
cost of, 129t
disadvantages of, 168
dosage of, 131t-132t
Monoamine oxidase inhibitors (continued)
drug interactions with, 67t,
84, 168
frequency of prescriptions for, 138t
physiological consequences of, 67t,
117
STEPS criteria for, 114t,
140-141
Mood stabilizers, 208-209
Mood symptoms, 13, 14t,
27
in different types of affective disorders,
16t
Motivation, 13
Muscarinic acetylcholine receptor blockers
adverse effects of, 195,
197
drugs for, 62t-63t
physiologic consequences of, 67t,
107t
TATCA effect on, 116
withdrawal from, 100t,
100-101
Myocardial infarction, 182t
Myths about depression, 11
Narcotics, fluvoxamine interaction with, 189-191
Nardil (phenelzine), 129t
Nausea, 198-199
Nefazodone (Serzone)
action mechanism of, 58t-59t,
62t-63t, 77,
83t
action site of, 80
adverse effects of, 72t-75t,
78t, 196,
200
cost of, 128t
CYP enzymes and, 91t,
94t, 157,
159-160
dosage of, 131t-133t,
158
ascending, 135
frequency of, 135
frequency of prescriptions for, 138t
half-life of, 95,
102
indications for, 160
pharmacokinetics of, 159-160
potency of, 86
sexual dysfunction and, 119
STEPS criteria for, 111t
withdrawal from, 102-103
Nervousness, 199
Nicardipine, 92t
Nifedipine, 92t
Niludipine, 92t
Nisoldipine, 92t
Nitrendipine, 92t
Norepinephrine, 17, 25
Norepinephrine selective reuptake inhibitors, 62t-63t.
See
also specific drugs.
action mechanism of, 58t-59t,
62t-63t, 67t,
119
action site of, 62t,
66t
adverse effects of, 198
cost of, 126t-127t
dosage of, 130t,
132t-133t
starting, 124
drug interactions with, 67t
efficacy of, 121-122
frequency of prescriptions for, 138t
hypertension from, 115
physiological consequences of, 66t,
195
STEPS criteria for, 108t,
144-145
Norpramin. See Desipramine.
Nortriptyline (Pamelor, Aventyl)
action mechanism of, 58t-59t
cost of, 126t
dosage of, 130t,
132t
starting, 124
frequency of prescriptions for, 138t
hypertension from, 115
STEPS criteria for, 108t
Occupational impairment, 15t,
23-24, 28,
43
Olanzapine, 90t
Omeprazole, 92t
Onset age. See Age.
Opiates, 90t-91t
Paclitaxel, 92t
Pain, chronic, 182t
Pamelor. See Nortriptyline.
Pancreatic carcinoma, 17
Paracetamol, 90t
Parkinson’s disease
bupropion for, 167-168
depression with, 182t,
204
drug interactions in, 186-188
Parnate. See Tranylcypromine.
Paroxetine (Paxil)
action mechanism of, 58t-59t
adverse effects of, 68t-71t,
76t
cost of, 127t
CYP enzymes and, 91t,
94t, 97t,
102, 150-151
dosage of, 82,
131t-133t
starting, 124
drug interactions with, 150-151,
187
frequency of prescriptions for, 137,
138t
indications for, 148t
potency of, 85
STEPS criteria for, 109t
withdrawal from, 102,
150
Patient education
about antidepressant drug therapy, 47-48,
54-55, 55t
about depression, 46-47
Paxil. See Paroxetine.
Perhexiline, 91t
Periactin (cyproheptadine), 199
Perphenazine, 91t
Phenelzine (Nardil), 129t
Phenformin, 91t
Phenytoin, 90t, 188-189
Pindolol, 204
Placebo response, 53t, 53-54
Posicor (mibefradil), 88
Postpartum depression, 24-25
Prazosin, 83t
Prevalence of depression, 11,
21
cost of, to employers, 23
recurrent, 21,
46-48
unipolar, 22t
Priapism, 119
Primary-care setting in depression
diagnosis in, 27-28.
See also Diagnosis of depression.
management in, 11-12
Progesterone, 92t
Prognosis of depression, 26
Propafenone, 91t
Propranolol, 90t-91t
Protriptyline (Vivactil)
action mechanism of, 58t-59t
hypertension from, 115
STEPS criteria for, 108t
Prozac. See Fluoxetine.
Psychomotor agitation or retardation, 14t
Psychomotor restlessness, 36
Psychosis assessment, 42
Psychostimulants, 203-204
Psychotherapy
medication with, 45
necessity for, 45-46
Quetiapine, 92t
Quinidine
action mechanism of, 83t
CYP enzymes and, 91t
Rational thinking, suicide risk and, 40t
Recurrence of depression
frequency of, 21
patient education about, 46-48
unipolar, 22t
Remeron. See Mirtazapine.
Renal impairment
antidepressant dosage in, 130t-131t
depression with, 182t
Responsiveness of patient, in diagnosis of depression, 34t,
36
Reuptake and neuroreceptor antagonists
action site of, 62t,
66t
physiological effects of, 66t
Risk groups for depression, 17
Risperidone, 91t
Rule of seven, 23t
SAD PERSONS scale, 40t
Safety, in antidepressant drug therapy, 105-106,
106t-114t, 115-118
Secondary amine tricyclic antidepressants (SATCAs),
143. See also Desipramine.
action mechanisms of, 143-144
advantages of, 144-146
disadvantages of, 146
history of, 143
STEPS criteria for, 144-146
Seizures, 119, 165,
167, 188-189
Seldane (terfenadine), 88
Self-esteem, 27
Serotonin, 17
estrogen and, 25
Serotonin and alpha-2 norepinephrine receptor blockers. See
also specific drugs.
action mechanism of, 58t-59t,
62t-63t, 161
advantages of, 162
cost of, 129t
disadvantages of, 163-164
dosage of, 131t-132t
frequency of prescriptions for, 138t
STEPS criteria for, 112t,
162-163
Serotonin and norepinephrine reuptake inhibitors. See also
specific drugs.
action mechanism of, 58t-59t,
62t-63t, 156
action site of, 77
advantages of, 153-155
availability of, 153
cost of, 128t
disadvantages of, 155-156
dosage of, 131t-133t
drug interactions with, 153
frequency of prescriptions for, 138t
hypertension from, 115
STEPS criteria for, 110t,
153-155
withdrawal from, 155
Serotonin receptor blockers
drug interactions with, 67t
drugs for, 62t-63t
physiological consequences of, 66t
Serotonin selective reuptake inhibitors. See also specific
drugs.
action mechanism of, 58t-59t,
62t-63t
action site of, 77
advantages of, 146,
149
cost of, 127t
disadvantages of, 149-152,
194-196, 200
dosage of, 125,
130t-133t, 134-135
drug interactions with, 150-151,
184-190
efficacy of, 121-122,
149
Serotonin selective reuptake inhibitors (continued)
frequency of prescriptions for, 137,
138t
indications for, 148t
sleep disturbances with, 197-198
STEPS criteria for, 109t,
147, 149
withdrawal from, 100-101,
101t, 150
Serotonin syndrome, 67t, 84,
109t, 117,
150
Serotonin-2A receptor blocker and weak serotonin uptake
inhibitors. See also specific drugs.
action mechanism of, 58t-59t,
62t-63t
advantages of, 157
cost of, 128t
CYP enzymes and, 159-161
disadvantages of, 157-161,
195
dosage of, 131t-133t
drug interactions with, 157
frequency of prescriptions for, 138t,
156-157
pharmacokinetics of, 159
STEPS criteria for, 111t,
157-159
Sertraline (Zoloft)
action mechanism of, 58t-59t,
62t-63t, 83t
action site of, 80,
81
advantages of, 152
adverse effects of, 68t-71t,
76t
cost of, 127t
CYP enzymes and, 91t,
94t, 97t
dosage of, 82,
131t, 133t
frequency of prescriptions for, 138t
indications for, 12,
148t
potency of, 85
STEPS criteria for, 109t
withdrawal from, 102
Serzone. See Nefazodone.
Sex drive, 13
in different types of affective disorders,
16t
Sexual dysfunction, 199
antidepressant-induced, 118-119
Sildenafil (Viagra), 197
Sinequan. See Doxepin.
Sleep patterns, 13, 14t,
27
in different types of affective disorders,
16t
Social history, in diagnosis of depression, 30,
33
Social withdrawal/isolation, 15t,
28, 35t
suicide risk and, 40t
Sodium channel. See Fast Na+ channel blockade.
Somatization disorder, 36
Sparteine, 91t
STEPS (safety-tolerability-efficacy-payment-simplicity)
criteria, 50, 105,
106t
for dopamine and norepinephrine reuptake
inhibitors, 113t, 164-167
for mixed reuptake and neuroreceptor antagonists,
107t, 140-141
for monoamine oxidase inhibitors, 114t,
140-141
for norepinephrine selective reuptake inhibitors,
108t, 144-145
for serotonin and alpha-2 norepinephrine
receptor
antagonists, 112t,
162-163
for serotonin and norepinephrine reuptake
inhibitors, 110t, 153-155
for serotonin selective reuptake inhibitors,
109t, 147,
149
for serotonin-2A receptor antagonists and
weak serotonin
reuptake inhibitors, 111t,
157-159
for TATCAs, 140-141
Steroids, 92t
Stress tolerance, 34t, 43
Stroke, 182t, 204
Substance abuse in depression
as cause, 17,
33
as symptom, 15t,
21, 23
Suicide, 21
ideation involving, 14t,
41-42
incidence of, 21
previous attempts at, 39,
40t
risk of, 39-42,
40t, 184-186
rule of seven in, 23t
SAD PERSONS scale in, 40t
in unipolar disorder, 22t
Surmontil (trimipramine), 58t-59t
Tacrine, 90t
Tacrolimus, 92t
Tamoxifen, 92t
TATCAs. See Tertiary amine tricyclic antidepressants.
Terfenadine (Seldane), 88, 92t
Tertiary amine tricyclic antidepressants (TATCAs). See
also specific drugs.
action sites and mechanisms of, 80,
81, 82
acute therapeutic index of, 105-106,
115
advantages of, 140
adverse effects of, 83-84
cost of, 126t
disadvantages of, 141-142
dosage of, 141-142
monitoring of, 134
drug interactions with, 116-117
efficacy of
acute, 121
prophylactic, 123
frequency of prescriptions for, 138t,
139
indications for, 141-142
lethality of, 83
pharmacology of, 82-83
sexual dysfunction and, 119
STEPS criteria for, 140-142
Testosterone, 92t
Theophylline, 90t
Thioridazine, 90t, 91t
Thyroid supplementation, as augmentation strategy, 203
Timolol, 91t
Tofranil-PM. See Imipramine.
Tolbutamide, 90t
Tolerability, in antidepressant drug therapy, 118-119
Tranylcypromine (Parnate)
action mechanism of, 62t
cost of, 129t
STEPS criteria for, 114t
Trazodone (Desyrel)
action mechanism of, 58t-59t,
80
cost of, 128t
dosage of, 131t-133t
frequency of prescriptions for, 138t
priapism from, 119
STEPS criteria for, 111t
Treatment of depression. See also Antidepressant drug
therapy.
advances in, 26
communicating with patient in. See Communicating
with
patient.
hospitalization decision in, 42-43
initiating outpatient therapy in, 43t,
43-48
response vs remission in, 52,
53t
timing of, 38
Triacetyloleandomycin, 92t
Triazolam, 92t
Tricyclic antidepressants. See also Tertiary amine
tricyclic antidepressants (TATCAs).
acute therapeutic index of, 106
cardiac toxicity of, 118
drug interaction with, 184-186
Trimipramine (Surmontil), 58t-59t
Unipolar disorder
duration of, 22t
prevalence of, 18,
22t
recurrent, 22t
suicide in, 22t
vs bipolar disorder, 16t, 17
Valproate, 208-209
Venlafaxine (Effexor)
action mechanism of, 58t-59t,
62t-63t, 156
action site of, 77,
80
advantages of, 153-155
adverse effects of, 72t-75t,
78t, 135,
194, 196,
199
cost of, 128t
CYP enzymes and, 91t,
94t
disadvantages of, 155-156
dosage of, 131t-133t
ascending, 135
starting, 124
drug interactions with, 153
efficacy of, 121
frequency of prescriptions for, 138t
half-life of, 95,
155
hypertension from, 115
potency of, 86
STEPS criteria for, 110t,
153-154
withdrawal from, 102,
155
Verapamil, 92t
Viagra (sildenafil), 197
Visual disturbance, 200
Vivactil. See Protriptyline.
Warfarin, 90t
Weight changes, 13, 14t,
27
in children, 14t
in malignancies, 17
Wellbutrin. See Bupropion.
Workplace, 15t, 23-24,
28, 43
Worthlessness feelings, 14t
Yocon (yohimbine), 83t, 199
Yohimbine (Aphrodyne, Erex, Yocon, Yohimex), 83t,
199
Yohimex (yohimbine), 83t, 199
Zoloft. See Sertraline.
Zung Depression Self-Report Rating Scale, 176-177,
177
Zyban. See Bupropion.
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