Depression: Treating To Recovery

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Overview

   Depression is a common medical illness with a lifetime prevalence of 15 to 20%. The disorder impacts people of all ages, from children to elders, and is more common among women than men. Depression can “look” very different in different individuals. While one depressed person may be anxious and agitated with many physical complaints, another may look slow, withdrawn, and apathetic.

   Effective treatments include antidepressant medication, cognitive behavioral therapy (CBT), and electroconvulsive therapy (ECT). The key to successful therapy is treating to full remission – which usually involves switching from one treatment to another and/or using combination therapy.

What Can the Community Practitioner Do?
   Community practitioners play a central role in recognizing the signs and symptoms of depression. When depression is suspected or diagnosed, patients and families can be counseled about the need for effective treatment in order to improve health and prevent suicide. Sharing information about the safety of antidepressants is important. Patients may be afraid to fill their prescriptions due to fear of addiction or the recent FDA warnings on increased suicidality with antidepressants. “Stigma-busting” is essential, as many still view depression as a weakness that those afflicted should just “snap out of."

   This issue has the information you need to recommend optimal antidepressants, appropriate doses, and effective dosing strategies. Tables offer a quick summary of common side effects and important antidepressant drug interactions so you can help patients avoid adverse effects. The Patient Connection page answers the most common questions about antidepressants, and includes practical advice on sexual side effects.

Publication Date: Sep-1-08
Expiration Date: Sep-1-11
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Dr. Julie Dopheide, Associate Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences, University of Southern California Schools of Pharmacy and Medicine, and Dr. Glen Stimmel, Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences, Schools of Pharmacy and Medicine, University of Southern California, Los Angeles, California.

Disclosure Statement

Dr. Dopheide has received honoraria from Shire for online CE on ADHD. Dr. Stimmel is a member of the national pharmacy advisory boards of Eli Lilly and Company and Janssen, a division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.

Editorial and Review Board

Editor and CE Administrator Terry M. Baker, PharmD Associate Editor and CE Coordinator Tracy Farnen, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Associate Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Julio R. Lopez, PharmD, FCSHP Chief of Pharmacy Service VA Northern California Health Care System Adjunct Clinical Professor College of Pharmacy Touro University Vallejo, CA Assistant Clinical Professor School of Pharmacy University of California, San Francisco San Francisco, CA

Adjunct Professor Thomas J. Long School of Pharmacy University of the Pacific Stockton, CA Visiting Associate Professor and Lecturer Nursing School Samuel Merritt University Oakland, CA Pamela Mausner, MD Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University And Elder Services of Spokane Spokane, WA Candy Tsourounis, PharmD Professor of Clinical Pharmacy Medication Outcomes Center Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Jocelyn Chan, PharmD Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Cynthia Chan Huang, PharmD, MBA Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

1. Describe the diverse clinical presentation of major depression, the diagnostic criteria, and the usual course of illness over a lifetime.
2. Design a treatment plan for a patient with major depression, including drug and nondrug options, monitoring, and counseling. Individualize treatment based on potential side effects and drug interactions, coexisting health conditions, and patient preferences.
3. Recognize suicide risk factors and counsel a patient about the risk of suicide linked with antidepressant therapy and the risks of untreated depression.