| Managing Depression in Clinical Practice | 3 |
|---|
| Contents | 5 |
| Author biographies | 7 |
| Preface | 9 |
| Chapter 1 Classification, causes, and epidemiology | 11 |
| Different types of depression | 11 |
| Depressive disorders | 11 |
| Causes of depression | 15 |
| Epidemiology and natural history | 18 |
| References | 20 |
| Chapter 2 Depression in different types of patients | 21 |
| Depression in children | 21 |
| Depression in elderly people | 22 |
| Depression in women | 23 |
| Depression in patients with comorbid medical conditions | 24 |
| References | 25 |
| Chapter 3 Diagnosis | 26 |
| Signs and symptoms of depression | 26 |
| Differential diagnosis | 28 |
| The patient examination and interview | 29 |
| Laboratory tests for co-occurring illnesses | 33 |
| References | 34 |
| Chapter 4 Principles of therapy | 35 |
| Goals of treatment | 35 |
| Rating scales for assessment of outcomes | 36 |
| Acute treatment outcomes | 36 |
| Medium- and long-term treatment outcomes | 38 |
| Treatment options | 39 |
| Nonspecific effects and placebo | 39 |
| Specific treatment options | 39 |
| Choice of treatment | 40 |
| Thresholds for benefit from specific treatments | 40 |
| Choice between specific treatments | 42 |
| Practicalities of treatment | 43 |
| Evaluation of risk, education, and agreeing treatment | 43 |
| Special populations | 45 |
| Children and adolescents | 45 |
| Elderly people | 45 |
| Pregnancy and breastfeeding | 46 |
| Initiating treatment | 46 |
| Monitoring and adjusting treatment | 47 |
| Service structure in delivery of treatment | 48 |
| Factors affecting response to treatment | 49 |
| References | 50 |
| Chapter 5 Medications | 52 |
| Selective serotonin reuptake inhibitors | 53 |
| Serotonin and norepinephrine reuptake inhibitors | 55 |
| Venlafaxine | 55 |
| Duloxetine | 56 |
| Milnacipran | 56 |
| Monoamine receptor antagonist drugs | 56 |
| Trazodone and nefazodone | 56 |
| Mirtazapine | 57 |
| Norepinephrine reuptake inhibitors | 58 |
| Reboxetine | 58 |
| Dopamine reuptake inhibitors | 58 |
| Bupropion (amfebutamone) | 58 |
| Tricyclic antidepressants | 59 |
| Monoamine oxidase inhibitors | 61 |
| Other drugs | 62 |
| New compounds | 62 |
| Augmentation strategies | 63 |
| Specific adverse effects of antidepressants | 63 |
| Serotonin syndrome | 63 |
| Antidepressant discontinuation syndrome | 63 |
| Suicidality | 64 |
| References | 65 |
| Chapter 6 Other treatments | 66 |
| Psychotherapy for depression | 66 |
| Combination psychotherapy and psychopharmacotherapy for depression | 68 |
| Physical treatments | 71 |
| Electroconvulsive therapy | 71 |
| Phototherapy | 73 |
| Other physical treatments | 73 |
| Vagus nerve stimulation | 74 |
| Transcranial magnetic stimulation | 74 |
| Deep brain stimulation | 75 |
| Lifestyle and complementary therapies | 75 |
| Exercise | 76 |
| St John s wort | 77 |
| Omega-3-fatty acids | 77 |
| Acupuncture | 78 |
| References | 80 |
| Chapter 7 Management of treatment nonresponse | 83 |
| Assessment and principles of management | 83 |
| Assessment | 83 |
| Principles of management | 84 |
| Definitions: treatment nonresponse and treatment-resistant depression | 85 |
| Medication strategies | 86 |
| Dose increase | 86 |
| Switching treatment | 86 |
| Combining treatments | 87 |
| Psychological treatment strategies | 88 |
| Physical treatment strategies | 89 |
| References | 90 |
| Chapter 8 Continuation and maintenance treatment | 91 |
| Goals of continuation/maintenance treatment | 91 |
| Phases of treatment | 91 |
| Medication | 92 |
| Psychological treatments | 93 |
| Physical treatments | 94 |
| Risk factors for relapse and recurrence | 94 |
| Longer-term treatment in practice | 94 |
| References | 96 |
| Index | 97 |
