Diagnosis
Proper medical history and relevant physical examination, including mental state exam are essential for …show more content…
Severe depression without psychotic features: Pharmacotherapy, combined pharmacotherapy and psychotherapy. However; American Psychiatrist Association doesn’t recommend Psychotherapy alone for severe Depression.
Severe depression with psychotic features: Antidepressant and Antipsychotic agents should be used, with or without psychotherapy.
According to the American Psychiatrist Association, ECT can be considered any stage of depression as a treatment modality. ECT is a highly effective treatment modality for depression and onset of action often seen after 1 week of treatment compared to other modalities. Often ECT is considered in following circumstances. …show more content…
Adverse Effects Fewer than TCA, therefore increased compliance CNS: restlessness, tremor, insomnia, headache, drowsiness GI: N/V, diarrhea, abdominal cramps, weight loss Sexual dysfunction: impotence, anorgasmia CVS: increased HR, conduction delay, serotonin syndrome, EPS, SIADH Low dose side effects include insomnia (serotonergic) Higher dose side effects include: tremors, tachycardia, sweating, insomnia, dose-dependent increase in diastolic BP (noradrenergic Anticholinergic effects: (Dry mouth, urinary retention, constipation, blurred vision, toxic-confusional states) Noradrenergic effects: tremors, tachycardia, sweating, insomnia, erectile and ejaculation problems -1 adrenergic effects: orthostatic hypotension Antihistamine effects: sedation, weight gain CNS: sedation, stimulation, L seizure threshold CVS: K HR, conduction