Unipolar Depression treatments

Treatments and A02 points for Unipolar depression

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  • Treatments for Depression
    • ANTI-DEPRESSANT DRUGS
      • dosage must be adjusted often
      • Tricyclics
        • Work by preventing the reuptake of serotonin & noradrenalin.
          • S & N levels are increased, so may fire longer and more easily
            • Effective in about 60% of patients who successfully complete the medication
              • Side effects – dry mouth, excessive perspiration, constipation& can be fatal when overdosed
                • 6-8 weeks on average to start working unlike 3 weeks for SSRIS. 
                  • Patients with severe depression may not be willing to wait so long.
      • MAO inhibitors
    • ECT (last resort treatment)
      • Two electrodes placed at side of head & an electric current 65-140V sent through brain for 0.5s
        • Causes ALL neurons to fire at once causing a massive release of neurotransmitters.
          • Treatment is daily from a few weeks to 4 months
      • Fink
        • Found 60-70% of patients who had ECT reported a reduction in UD symptoms. 
          • The exact mechanism of ECT is not fully understood.
            • Side effects – severe memory loss, can lose months of memories
              • High RR – 80% of patients need further treatment. Good in short term not in long term. 
  • ECT (last resort treatment)
    • Two electrodes placed at side of head & an electric current 65-140V sent through brain for 0.5s
      • Causes ALL neurons to fire at once causing a massive release of neurotransmitters.
        • Treatment is daily from a few weeks to 4 months
    • Fink
      • Found 60-70% of patients who had ECT reported a reduction in UD symptoms. 
        • The exact mechanism of ECT is not fully understood.
          • Side effects – severe memory loss, can lose months of memories
            • High RR – 80% of patients need further treatment. Good in short term not in long term. 
  • ANTI-DEPRESSANT DRUGS
    • dosage must be adjusted often
    • Tricyclics
      • Work by preventing the reuptake of serotonin & noradrenalin.
        • S & N levels are increased, so may fire longer and more easily
          • Effective in about 60% of patients who successfully complete the medication
            • Side effects – dry mouth, excessive perspiration, constipation& can be fatal when overdosed
              • 6-8 weeks on average to start working unlike 3 weeks for SSRIS. 
                • Patients with severe depression may not be willing to wait so long.
    • MAO inhibitors
  • Enzyme which breaks down noradrenalin
    • Has evidence that MAOI’s have helped a large number of mild to severe depressed patients.
      • Adverse side effects such as avoiding wine & choc or else patients may experience weight gain, liver damage or increase in blood pressure.
  • Adverse side effects such as avoiding wine & choc or else patients may experience weight gain, liver damage or increase in blood pressure.
  • SSRIS
    • Treatments for Depression
      • ELKIN
        • an experimental group and a placebo group 
          • Actually reduces the symptoms of D faster than cog therapy & psychotherapy
    • Work by preventing unused serotonin being re-absorbed, making serotonin more available
      • SSRI’s are fast acting compared to tricyclics and MAOI’s  (2 weeks) 
        • reduced risk of overdose compared to older tricyclic alternatives. 
        • Side effects – cause insomnia or make it worse.
      • SSRIS
        • ELKIN
          • an experimental group and a placebo group 
            • Actually reduces the symptoms of D faster than cog therapy & psychotherapy
    • Neurons may fire more rapidly & serotonin remains active for longer.
      • Work by preventing unused serotonin being re-absorbed, making serotonin more available
        • SSRI’s are fast acting compared to tricyclics and MAOI’s  (2 weeks) 
          • reduced risk of overdose compared to older tricyclic alternatives. 
          • Side effects – cause insomnia or make it worse.
    • Given first to patients with depression & given alternatives if innaffective
      • 50-60%
      • 29%

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