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Depression: Treating To Recovery

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   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 While one depressed person may be anxious and agitated with many physical complaints, another may look slow, withdrawn, and apathetic.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: 09/01/2008
Expiration Date: 09/01/2011
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.


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.

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 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.

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: 428-0000-08-008-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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