Posted by stjames on September 27, 2000, at 10:16:12
By way of McMan's Depression and Bipolar Weekly2#35, as published in XXIInd Congress of the Collegium Internationale Neuro-Psychopharmacologicum, at
http://psychiatry.medscape.com/Medscape/CNO/2000/CINP/Story.cfm?story_id=1500McMan's abstract of this article:
TREATING DEPRESSIONA Medscape article by Thomas Kramer MD looks at medication treatment strategies for depression. Some highlights:
* Men respond better to Tofranil and Serzone, women to Zoloft.
* Co-occurring symptoms such as anxiety have not predicted treatment response to different medications.
* For severe depression, Anafranil has been shown superior to SSRIs, and Remeron more effective than Prozac. Effexor has been shown superior to Prozac for melancholic depression.
* Biological markers such as platelet serotonin levels have proved to be disappointing predictors of treatment response.
* Lack of treatment response over six to eight weeks is reasonably predictive of no further response, but four weeks is too soon to tell.As for augmentation strategies:
* Lithium is seldom used due to its low therapeutic window and side effects.
* Buspar is easy to use and is well-tolerated, but results have been negative at less than 30 mg a day.
* Serzone has achieved good results, but there is concern with drug-drug interactions.
* Dopamine drugs such as Symmetrel and Mirapex may be effective augmenters and counters to SSRI sexual dysfunction.
* Stimulants work quickly, but can cause anxiety and irritability.
* Wellbutrin is used widely to counteract SSRI sexual dysfunction, but can cause tremor or panic attacks.
* Effexor can be effective due to its dual serotonin and noradrenergic action, but may cause drug-drug interactions or high blood pressure.
* Remeron also has dual action and may be helpful treating sexual dysfunction, but may cause weight gain and sedation.
* Atypical antipsychotics and anticonvulsants have been reported to have good results.SUBSCRIBE/UNSUBSCRIBE
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poster:stjames
thread:45354
URL: http://www.dr-bob.org/babble/20000926/msgs/45354.html