Antidepressants needed?
May 22, 2012
NON-drug therapies should be
used as first line for mild
depression, and in combination
with antidepressants for more
severe depression, according to
NPS.
The comments come on the back
of the release of NPS’ latest
therapeutic program Depression:
Challenges in primary care, which
encourages healthcare providers to
carefully assess the severity of
depressive symptoms in patients
diagnosed with major depressive
disorder and then consider
whether an antidepressant is
necessary.
“When determining if a patient
could benefit from taking an
antidepressant, a global
assessment of the severity of their
symptoms should be made, with
particular consideration of the
degree to which their day to day
functioning is impaired and
whether they have had suicidal
thoughts or intent,” said NPS
clinical adviser Dr Danielle
Stowasser.
In addition, the NPS said that
healthcare practitioners who are
looking to use antidepressants in
treating their patients, should
consider the patient’s previous
experience with antidepressants,
along with potential drug
interactions and the likelihood of
adverse events, such as weight
gain, sexual dysfunction and
gastrointestinal upset.
“It is particularly important to
assess the balance of benefits and
harms in older patients, since they
experience adverse effects and
drug interactions more frequently
than younger patients,” Stowasser
said.
According to NPS, between onethird
and one-half of patients
prescribed an antidepressant
discontinue within three months of
starting treatment.
The major factors contributing to
these discontinuations include: side
effects, and a lack of understanding
of depression as a condition and
what to expect from treatment.
To remedy this, NPS suggests that
healthcare professionals discuss
issues related to antidepressant
therapy with their patients
including: potential side effects,
how long before the full benefit of
treatment is likely to be
experienced, likely duration of
treatment, dangers of
non-adherence and of stopping
treatment abruptly, concerns about
addiction, and interactions with
over-the-counter medicines such as
St John’s Wort and many cough and
cold medicines.
For more information seewww.
nps.org.au/conditions/
depression.
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