En syvpunkts behandlingsstrategi for depresjoner som ikke responderer på vanlig psykofarmalogisk behandling
Ulrik Fredrik Malt
Bok Norsk
| Omfang | 10 s.
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| Utgave | Kopi
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| Opplysninger | About one-third of major depressive disorders do not respond satisfactorily to antidepressant medication. A seven.step strategy for handling non-responders is proposed. 1)Alvays start by checking that the drug is actually used. 2)Then the diagnosis should be reconsidered. If "organic" causes can be ruled out, 3) consider high-dosage treatment combined with 4) plasma concentration monitoring. 5) Electroconvulsive therapy (ECT) may be the treatment of choice in several cases. The alternatives to ECT are 6) to change to another type of drug or 7) to combine two antidepressants with different biochemical actions or combine an antidepressant with other pharmacologic agents or specific psychologic therapies. The latter step is discussed with special reference to the often successful combination of a "presynaptic" (mianserin) and synaptic drug (such as monoamine-reuptake inhibitors or monoamine oxidase inhibitors). The usefulness of using this drug combination in treating difficult psychosomatic cases is also discussed.
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