Clinical picture and pharmacotherapy of depression – review for psychiatrists and general practitioners Review article
Article Sidebar
Published:
Mar 31, 2014
Keywords:
antidepressants, general practitioner, treatment decision
Main Article Content
Abstract
The rate of diagnosis of new cases of depression in recent 20 years has increased tenfold in Poland. Forecasts of World Health Organization are increasingly worrisome and there are visible consequences of how these forecasts becoming real. Depression has become a disease of civilization, with increasing level of disability among the population. Unfortunately, still the main costs of depression are not ones spending on health care, nor the costs associated with refunding drugs but resources which are used to pay pensions and sick leaves for people suffering from affective disorders. Patients start treatment too late and because of inaccurate diagnoses or not entirely well-profiled medicines, drop out the treatment. Due to long-term complications of depression, there are some serious consequences: somatic disorders, immune disorders, chronic fatigue and increased muscle pain and tension or even suicides. Faster intervention (GP level), better awareness of different clinical pictures of depression as well as knowledge of pharmacology of antidepressants can considerably shorten the duration of illness hence faster recovery. An extremely important issue is to minimize the risk of recurrence of affective disorders which can be achieved through continuity of treatment (at least 6 months regular intake of antidepressant).
Article Details
Issue
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: © Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
1. Łoza B, Parnowski T. Nowa depresja. Nowe leczenie. Wyd. I. Medical Education; Warszawa 2012: 47-84.
2. Mosiołek A. Depresja i terapia tianeptyną. Neuropsychiatria. Przegląd Kliniczny 2012; 4(2): 69-74.
3. Angst J, Angst F, Stossen HM. Suicide risk in patients with major depressive disorders, Journal of Clinical Psychiatry 1999; 60(Suppl. 2): 57-62.
4. Schimelpfening N. Which doctor is best for treating depression? About.com Depression 2012.
5. Łoza B. Kiedy lekarze rodzinni w Polsce zaczną leczyć zaburzenia depresyjne. Neuropsychiatria. Przegląd Kliniczny 2013; 5(1): 31-36.
6. Łoza B. Jak zmierzyć równocześnie lęk i depresję. Szpitalna Skala Lęku i Depresji. Wiadomości Psychiatryczne 2011; 14(4): 3-7.
7. Kendrick T, King F, Albertella l, Smith PW. GP treatment decisions for patient with depression: an observational study. Br J Gen Pract. 2005; 55(513): 280-286.
8. Depresja. WHO.
9. Tylee A. Depression in Europe: experience from the DEPRES II survey. Depression Research in European Society. Eur Neuropsychopharmacol 2000; 10(Suppl 4): S445-8.
10. Kessler RC, Zhao S, Blazer DG, Swart M. Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord 1997; 45: 19-30.
11. Dróżdż W, Wojnar M et al. Badanie rozpowszechnienia zaburzeń depresyjnych u pacjentów podstawowej opieki zdrowotnej w Polsce. Wiadomości Lekarskie 2007; LX: 3-4.
12. Nimalasuriya K, Compton MT, Guillory VJ. Prevention Practice Committee of American College of Preventive Medicine. Family Practice 2009; 58(10): 535-538.
13. IPiN. Zakłady Psychiatrycznej oraz neurologicznej opieki zdrowotnej. Rocznik Statystyczny 2009 IPiN, Warszawa 2010: 211.
14. Murawiec S, Mosiołek A. Neuropsychologiczna poznawcza hipoteza działania leków przeciwdepresyjnych – przegląd piśmiennictwa. Psychiatria Polska 2010; XLIV(6): 871-880.
15. Pużyński S, Rybakowski J, Wciorka J. Psychiatria. Psychiatria kliniczna T. II. Elsevier Urban&Partner; Wrocław 2011: 305-376.
16. Kieholz P. Masked Depression. H. Huber; Bern 1973.
17. Simon GE, VonKorff M, Piccinelli M, Fullerton C, Ormel J. An international study of the relation between somatic symptoms and depression. N Engl J Med. 1999; 341(18): 1329-35.
18. Łoza B. Escitalopram: odkrycie leku i jego rozwój. Neuropsychiatria. Przegląd Kliniczny 2011; 3(1): 5-14.
19. Parnowski T, Łoza B. Rozwój leczenia przeciwdepresyjnego. W: Łoza B. Parnowski T. Nowa depresja. Nowe leczenie. Wydanie pierwsze. Medical Education; Warszawa 2012: 7-46.
20. Stahl S. Antidepressants. Cambridge University Press; Neuroscience Education Institute 2009: 8-46.
21. Stahl S. Podstawy psychofarmakologii. Teoria i praktyka. T. 2. Via Medica Sp. z o.o.; Gdańsk 2009: 236-252.
22. Dudek D. Leczenie depresji w przebiegu choroby afektywnej jednobiegunowej. W: Standardy leczenia farmakologicznego w niektórych zaburzeniach psychicznych. Jarema M (red.). Via Medica; Gdańsk 2011: 48-53.
23. Leonard B, Taylor D. Escitalopram – translating molecular properties into clinical benefit; reviewing the evidence in major depression. Journal of Psychopharmacology 2010; 24: 1143-1152.
24. Bostwick JM. Generalist’s Guide to Treating Patients With an Emphasis on Using Side Effects to Tailor Antidepressant Therapy. Mayo Clin Proc 2010; 85: 538-550.
25. Baldwin DS, Reines EH, Guiton C, Weiller E: Escitalopram therapy for major depression and anxiety disorders. Ann Pharmacother 2007; 41: 1583-1592.
26. Hansen BH, Hanash JA, Rasmussen A. Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of depression in acute coronary syndrome (DECARD). Trials 2009; 10(1): 20.
27. Clayaton AH, Croft HA, Horrigan JP, Wightman DS, Krishen A, Richard NE, Modell JG. Bupropion extended release compared with escitalopram: effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies. J Clin Psychiatry 2006; 67: 736-746.
28. Goodman WK, Bose A, Wang Q. Treatment of generalized anxiety disorder with escitalopram: pooled results from double- blind, placebo-controlled trail. J Affect Disord 2005; 87: 161-167.
29. Davidson JRT, Bose A, Wang Q. Safety and efficacy of escitalopram in the long-term treatment of generalized anxiety disorder. J Clin Psychiatry 2005; 66: 1441-1446.
30. Stahl SM, Gergel I, Li D. Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 2003; 64: 1322-1327.
31. Burke WJ, Kratochvil CJ. Stereoisomers in psychiatry: case of escitalopram. Primary Care Companion. J Clin Psychiatry 2002; 4: 20-24.
32. Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, Churchill R, Barbui C. Escitalopram versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2009; 2.
33. Chauvet-Gélinier JC [Efficacy of escitalopram vs paroxetine on severe depression with associated anxiety: data from the “Boulenger” study]. Encephale 2010; 36(5): 425-32.
34. Ventura D, Armstrong EP, Skrepnek GH, Haim Erder M. Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial. Curr Med Res Opin 2007; 23(2): 245-50.
35. Lam RW, Andersen HF, Wade AG. Escitalopram and duloxetine in the treatment of major depressive disorder: a pooled analysis of two trials. Int Clin Psychopharmacol 2008; 23(4): 181-7.
36. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373(9665): 746-58.
37. Rahm C, Liberg B, Kristoffersen-Wiberg M, Aspelin P, Msghina M. Differential Effects of Single-Dose Escitalopram on Cognitive and Affective Interference during Stroop Task. Front Psychiatry 2014; 5: 21.
38. Wang L, Li K, Zhang Q, Zeng Y, Dai W, Su Y, Wang G, Tan Y, Jin Z, Yu X, Si T. Short-term effects of escitalopram on regional brain function in first-episode drug-naive patients with major depressive disorder assessed by resting-state functional magnetic resonance imaging. Psychol Med 2013 Aug 13: 1-10 [online].
39. Bielski RJ, Ventura D, Chang CC. A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychiatry 2004; 65(9): 1190-6.
40. Muth EA, Haskins JT, Moyer JA, Husbands GE, Nielsen ST, Sigg EB. Antidepressant biochemical profile of the novel bicyclic compound Wy-45,030, an ethyl cyclohexanol derivative. Biochem Pharmacol 1986; 35(24): 4493-7.
41. Bazire S. Przewodnik leków psychotropowych 2010. Via Medica, Gdańsk 2010: 85-200.
42. FDA.
43. Kwaśna J, Łoza B, Kwaśna A, Wnukiewicz P, Mosiołek A. Zespół odstawienny po lekach przeciwdepresyjnych. Neuropsychiatria. Przegląd Kliniczny 2011; 3(1): 39-44.
44. Pużyński S, Rybakowski J, Wciorka J. Psychiatria. Psychiatria kliniczna. T. III. Elsevier Urban&Partner; Wrocław 2011: 101-102.
45. Vuković O, Marić NP, Britvić D, Cvetić T, Damjanović A, Prostran M, Jasović-Gasić M. Efficacy, tolerability and safety of tianeptine in special populations of depressive patients. Psychiatr Danub 2009; 21(2): 194-8.
46. Dovzhenko TV, Vasiuk IuA, Semiglazova MV, Krasnov VN, Lebedev AV, Tarasova KV [The clinical picture and treatment of depression spectrum disorders in patients with cardiovascular disease]. Ter Arkh 2009; 81(12): 30-4.
47. El-Shafey H, Atteya A, el-Magd SA, Hassanein A, Fathy A, Shamloul R. Tianeptine can be effective in men with depression and erectile dysfunction. J Sex Med 2006; 3(5): 910-7.
2. Mosiołek A. Depresja i terapia tianeptyną. Neuropsychiatria. Przegląd Kliniczny 2012; 4(2): 69-74.
3. Angst J, Angst F, Stossen HM. Suicide risk in patients with major depressive disorders, Journal of Clinical Psychiatry 1999; 60(Suppl. 2): 57-62.
4. Schimelpfening N. Which doctor is best for treating depression? About.com Depression 2012.
5. Łoza B. Kiedy lekarze rodzinni w Polsce zaczną leczyć zaburzenia depresyjne. Neuropsychiatria. Przegląd Kliniczny 2013; 5(1): 31-36.
6. Łoza B. Jak zmierzyć równocześnie lęk i depresję. Szpitalna Skala Lęku i Depresji. Wiadomości Psychiatryczne 2011; 14(4): 3-7.
7. Kendrick T, King F, Albertella l, Smith PW. GP treatment decisions for patient with depression: an observational study. Br J Gen Pract. 2005; 55(513): 280-286.
8. Depresja. WHO.
9. Tylee A. Depression in Europe: experience from the DEPRES II survey. Depression Research in European Society. Eur Neuropsychopharmacol 2000; 10(Suppl 4): S445-8.
10. Kessler RC, Zhao S, Blazer DG, Swart M. Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord 1997; 45: 19-30.
11. Dróżdż W, Wojnar M et al. Badanie rozpowszechnienia zaburzeń depresyjnych u pacjentów podstawowej opieki zdrowotnej w Polsce. Wiadomości Lekarskie 2007; LX: 3-4.
12. Nimalasuriya K, Compton MT, Guillory VJ. Prevention Practice Committee of American College of Preventive Medicine. Family Practice 2009; 58(10): 535-538.
13. IPiN. Zakłady Psychiatrycznej oraz neurologicznej opieki zdrowotnej. Rocznik Statystyczny 2009 IPiN, Warszawa 2010: 211.
14. Murawiec S, Mosiołek A. Neuropsychologiczna poznawcza hipoteza działania leków przeciwdepresyjnych – przegląd piśmiennictwa. Psychiatria Polska 2010; XLIV(6): 871-880.
15. Pużyński S, Rybakowski J, Wciorka J. Psychiatria. Psychiatria kliniczna T. II. Elsevier Urban&Partner; Wrocław 2011: 305-376.
16. Kieholz P. Masked Depression. H. Huber; Bern 1973.
17. Simon GE, VonKorff M, Piccinelli M, Fullerton C, Ormel J. An international study of the relation between somatic symptoms and depression. N Engl J Med. 1999; 341(18): 1329-35.
18. Łoza B. Escitalopram: odkrycie leku i jego rozwój. Neuropsychiatria. Przegląd Kliniczny 2011; 3(1): 5-14.
19. Parnowski T, Łoza B. Rozwój leczenia przeciwdepresyjnego. W: Łoza B. Parnowski T. Nowa depresja. Nowe leczenie. Wydanie pierwsze. Medical Education; Warszawa 2012: 7-46.
20. Stahl S. Antidepressants. Cambridge University Press; Neuroscience Education Institute 2009: 8-46.
21. Stahl S. Podstawy psychofarmakologii. Teoria i praktyka. T. 2. Via Medica Sp. z o.o.; Gdańsk 2009: 236-252.
22. Dudek D. Leczenie depresji w przebiegu choroby afektywnej jednobiegunowej. W: Standardy leczenia farmakologicznego w niektórych zaburzeniach psychicznych. Jarema M (red.). Via Medica; Gdańsk 2011: 48-53.
23. Leonard B, Taylor D. Escitalopram – translating molecular properties into clinical benefit; reviewing the evidence in major depression. Journal of Psychopharmacology 2010; 24: 1143-1152.
24. Bostwick JM. Generalist’s Guide to Treating Patients With an Emphasis on Using Side Effects to Tailor Antidepressant Therapy. Mayo Clin Proc 2010; 85: 538-550.
25. Baldwin DS, Reines EH, Guiton C, Weiller E: Escitalopram therapy for major depression and anxiety disorders. Ann Pharmacother 2007; 41: 1583-1592.
26. Hansen BH, Hanash JA, Rasmussen A. Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of depression in acute coronary syndrome (DECARD). Trials 2009; 10(1): 20.
27. Clayaton AH, Croft HA, Horrigan JP, Wightman DS, Krishen A, Richard NE, Modell JG. Bupropion extended release compared with escitalopram: effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies. J Clin Psychiatry 2006; 67: 736-746.
28. Goodman WK, Bose A, Wang Q. Treatment of generalized anxiety disorder with escitalopram: pooled results from double- blind, placebo-controlled trail. J Affect Disord 2005; 87: 161-167.
29. Davidson JRT, Bose A, Wang Q. Safety and efficacy of escitalopram in the long-term treatment of generalized anxiety disorder. J Clin Psychiatry 2005; 66: 1441-1446.
30. Stahl SM, Gergel I, Li D. Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 2003; 64: 1322-1327.
31. Burke WJ, Kratochvil CJ. Stereoisomers in psychiatry: case of escitalopram. Primary Care Companion. J Clin Psychiatry 2002; 4: 20-24.
32. Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, Churchill R, Barbui C. Escitalopram versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2009; 2.
33. Chauvet-Gélinier JC [Efficacy of escitalopram vs paroxetine on severe depression with associated anxiety: data from the “Boulenger” study]. Encephale 2010; 36(5): 425-32.
34. Ventura D, Armstrong EP, Skrepnek GH, Haim Erder M. Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial. Curr Med Res Opin 2007; 23(2): 245-50.
35. Lam RW, Andersen HF, Wade AG. Escitalopram and duloxetine in the treatment of major depressive disorder: a pooled analysis of two trials. Int Clin Psychopharmacol 2008; 23(4): 181-7.
36. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373(9665): 746-58.
37. Rahm C, Liberg B, Kristoffersen-Wiberg M, Aspelin P, Msghina M. Differential Effects of Single-Dose Escitalopram on Cognitive and Affective Interference during Stroop Task. Front Psychiatry 2014; 5: 21.
38. Wang L, Li K, Zhang Q, Zeng Y, Dai W, Su Y, Wang G, Tan Y, Jin Z, Yu X, Si T. Short-term effects of escitalopram on regional brain function in first-episode drug-naive patients with major depressive disorder assessed by resting-state functional magnetic resonance imaging. Psychol Med 2013 Aug 13: 1-10 [online].
39. Bielski RJ, Ventura D, Chang CC. A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychiatry 2004; 65(9): 1190-6.
40. Muth EA, Haskins JT, Moyer JA, Husbands GE, Nielsen ST, Sigg EB. Antidepressant biochemical profile of the novel bicyclic compound Wy-45,030, an ethyl cyclohexanol derivative. Biochem Pharmacol 1986; 35(24): 4493-7.
41. Bazire S. Przewodnik leków psychotropowych 2010. Via Medica, Gdańsk 2010: 85-200.
42. FDA.
43. Kwaśna J, Łoza B, Kwaśna A, Wnukiewicz P, Mosiołek A. Zespół odstawienny po lekach przeciwdepresyjnych. Neuropsychiatria. Przegląd Kliniczny 2011; 3(1): 39-44.
44. Pużyński S, Rybakowski J, Wciorka J. Psychiatria. Psychiatria kliniczna. T. III. Elsevier Urban&Partner; Wrocław 2011: 101-102.
45. Vuković O, Marić NP, Britvić D, Cvetić T, Damjanović A, Prostran M, Jasović-Gasić M. Efficacy, tolerability and safety of tianeptine in special populations of depressive patients. Psychiatr Danub 2009; 21(2): 194-8.
46. Dovzhenko TV, Vasiuk IuA, Semiglazova MV, Krasnov VN, Lebedev AV, Tarasova KV [The clinical picture and treatment of depression spectrum disorders in patients with cardiovascular disease]. Ter Arkh 2009; 81(12): 30-4.
47. El-Shafey H, Atteya A, el-Magd SA, Hassanein A, Fathy A, Shamloul R. Tianeptine can be effective in men with depression and erectile dysfunction. J Sex Med 2006; 3(5): 910-7.