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Depression: More Reasons & Options for Recovery

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Overview

Depression (major depressive disorder, or MDD) was the leading cause of disability worldwide in 2017. In 2015, 7-10% of adults and 10-12% of adolescents in the US suffered from MDD. Alarmingly, suicide completion rates in the US increased 24% from 1999 to 2014.5 In 2015, suicide was the second leading cause of death in 15-34 year olds and the third leading cause of death in 10-14 year olds. Depression is also a known contributor to the illness and death associated with chronic pain and diseases such as dementia, diabetes, and cerebrovascular and heart disease. Depression should be treated along with chronic medical problems to achieve the best outcome for all conditions.

Both the Agency for Healthcare Research and Quality (AHRQ) and the National Institute for Mental Health (NIMH) recommend psychotherapy and antidepressants as effective treatments for depression. Adding certain antipsychotics to antidepressant therapy may boost the response to antidepressants. There is increasing evidence that exercise, a healthy diet, and certain supplements (eg, omega-3, vitamin D, folate, SAM-e) also decrease depressive symptoms. Electroconvulsive therapy (ECT) and other types of brain stimulation are FDA-approved and recommended for treatment-resistant depression. Ketamine is being investigated for treatment-refractory depression, and is currently being used (off-label) for some treatment-refractory cases...

Details

Publication Date: 02/23/2018
Expiration Date: 02/23/2021
CE Credit: 1.5 (0.15 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

Julie Dopheide, PharmD, BCPP, FASHP is Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences at the University of Southern California School of Pharmacy and Keck School of Medicine in Los Angeles, CA. She is also the PGY2 psychiatric pharmacy residency program director and the director of pharmacy continuing education at the USC School of Pharmacy.

Disclosure Statement

Dr. Dopheide reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

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

    1. Describe the criteria for diagnosing depression and the rationale for using the PHQ-9 (patient health questionaire) and the MDQ (mood disorder questionaire) as additional screening tools.
    2. Discuss the role of psychotherapy in the treatment of depression.
    3. Compare the advantages (or disadvantages) of using SSRIs, SNRIs, multiple mechanism serotonergic agents, bupropion, and mirtazapine in the treatment of depression. Discuss combination therapy for the treatment of depression.
    4. Appraise the role of complementary therapeutics such as diet, exercise, fish oil, SAM-e, vitamin D, folate/methylfolate, and St. John’s wort in the management of major depression.

Accreditation Statements

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

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-18-002-H01-P


Exam & 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.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


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

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, 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

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

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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