Posted by jedi on January 15, 2007, at 17:44:43
In reply to Re: Qs about Melancholic depression - Jedi, posted by UgottaHaveHope on January 15, 2007, at 11:02:55
> Now what exactly is a melancholic depression? People who never are happy about anything? How is that treated or can it be? I might have it, Michael
Hi,
Wikipedia, the online encyclopedia, uses the definition in DSM-IV to define melancholic depression as:"Melancholic Depression, or 'depression with melancholic features' is a subtype of depression characterized by the inability to find pleasure in positive things combined with physical agitation, insomnia, or decreased appetite. Roughly 10% of people with depression suffer from Melancholic Depression.
Diagnostic criteria (DSM-IV-TR)
The DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines Depression with Melancholic Features as a subtype of depression characterized by:A. At least one of the following:
Loss of pleasure in all, or almost all, activities
Lack of mood reactivity to usually pleasurable stimuli (can't feel much better, even when something good happens)
B. At least three of the following:
Distinct quality of depressed mood (i.e., the depressed mood is experienced as distinctly different from the kind of feeling experienced after the death of a loved one)
Depression is regularly worse in the morning
Early morning awakening (at least 2 hours before usual time of awakening)
Marked psychomotor retardation or agitation
Significant anorexia or weight loss
Excessive or inappropriate guilt"TCAs(tricyclic antidepressants) or TCA with an augmentation are probably the best treatment for melancholic depression.
Jedi
"J Affect Disord. 1996 Jun 20;39(1):1-6.
Pharmacotherapy for major depression with melancholic features: relative efficacy of tricyclic versus selective serotonin reuptake inhibitor antidepressants.
Perry PJ.
Department of Psychiatry, College of Medicine, University of Iowa, Iowa City 52242, USA.The effectiveness of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) were contrasted in endogenous/melancholic depression. By reviewing Hamilton Depression Rating data from controlled trials, the data indicate that TCAs are consistently more effective than the SSRIs. Despite the wide use of SSRIs in the treatment of depression, it seems reasonable that clinicians subtype their depressed patients and treat melancholic patients first with a course of TCAs. For melancholic patients who have not responded to a SSRI, pharmacotherapeutic alternatives include (1) a TCA alone; (2) TCA augmentation of the SSRI, or (3) lithium augmentation of the SSRI.
PMID: 8835647 [PubMed - indexed for MEDLINE]"
poster:jedi
thread:722164
URL: http://www.dr-bob.org/babble/20070113/msgs/722630.html