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Treatment of depression
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When it comes to depression, did you know you are expected to actively participate in your treatment, whenever that is possible. In fact the # 1 deciding factor, for choosing a effective treatment, is supposed to be patient preference, especially for uncomplicated depression. By that I mean there is no history of failure to achieve remission, on a given antidepressant. The current consensus is that for uncomplicated depression either medication or psychotherapy are equally effective, so we can let the patient decide what he prefers to try first. However when the depression has only partially responded to a medication and there are residual symptoms, or there has been no response to a medication and the symptoms have become chronic and persistent, the depression is now labelled as complicated treatment resistant depression Now the decision is based on three factors 1 What is known to work ( Efficacy) 2 Minimal or no side efffects (Tolerability) 3 Patient consent (Acceptability) Now the doctor has the option of either 1 Switching when there is minimal or no response or there are intolerable side effects 2 Combining with another antidepressant 3 Augmenting with a non antidepressant Options 2 & 3 are used when there has been some response and no side effects are experienced Advantages of Switching There is greater support for efficacy of alternate antidepressant Monotherapy is preferable when possible because 1 Lower Cost 2 Less drug drug interaction 3 Less side effects 4 improved compliance
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