A female patient presented with depressed mood, loss of appetite and no interest in surroundings. There is associated insomnia. The onset of depression was preceded by a history of business loss and soon after it she developed the following symptoms for the past one year. True statement regarding management of this patient is?
Correct Answer: Start SSRI treatment based on side effect profile
Description: Ans. (C) Start SSRI treatment based on side effect profile(Ref: CMDT 2010/964)Depression associated with reactive disorders usually does not call for drug therapy and can be managed by psychotherapy and the passage of time. In severe cases -- particularly when vegetative signs are significant and symptoms have persisted for more than a few weeks -- antidepressant drug therapy is often effective. Drug therapy is also suggested by a family history of major depression in first-degree relatives or a past history of prior episodes.Drug selection is influenced by the history of previous responses if that information is available. If a relative has responded to a particular drug, this suggests that the patient may respond similarly. If no background information is available, a drug such as sertraline, 25 mg orally daily and increasing gradually up to 200 mg orally, or desipramine, starting with 50 mg orally and gradually increasing to 150 mg daily, can be selected and a full trial instituted. The medication trial should be monitored for worsening mood or suicidal ideation with patient assessments every 1-2 weeks until week 6. If successful, the medication should be continued for 6-12 months at the full therapeutic dose before tapering is considered.
Category:
Pharmacology
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