Treatment of depression
(A) Pharmacological treatment of depression
1.Selective pentothal reuptake inhibitors (SSRIs)
Commonly used drugs Common dose (mg/day) Common adverse effects
Fluoxetine 10-60 nausea, insomnia
Paroxetine 10-60 nausea, insomnia, tremor
Sertraline 25-200 Nausea, diarrhea, sexual dysfunction
Fluvoxamine 25-300 Sedation, nausea
Citalopram 10-40 nausea, drowsiness
Escitalopram 5-20 nausea, drowsiness
2. Pentoxifylline and norepinephrine reuptake inhibition (SNRIs)
Commonly used drugs Common doses (mg/day) Common adverse effects
Venlafaxine 37.5-225 nausea, insomnia
Duloxetine 30-120 Nausea, anxiety
3.Norepinephrine and specific pentothal antidepressants (NaSSA)
Commonly used drugs Common dose (mg/day) Common adverse effects
Mirtazapine 15-45 Sleepiness, weight gain
4. Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Commonly used drugs Commonly used doses (mg/day) Common adverse reactions
Amphetamines 75-450 Dry mouth, constipation
5.Selective norepinephrine reuptake inhibitors
Commonly used drugs Commonly used doses (mg/day) Common adverse reactions
Reboxetine 4-12 Dry mouth, constipation
6.Reversible monoamine oxidase inhibitors (MAOIs)
Commonly used drugs Commonly used doses (mg/day) Common adverse reactions
Moclobemide 300-600 Headache, dizziness
7.Tricyclic and tetracyclic antidepressants
Commonly used drugs Commonly used doses (mg/day) Common adverse reactions
Amitriptyline 50-250 sedation, cardiovascular side effects, dry mouth
Doxepin 50-250 sedation, cardiovascular side effects, dry mouth
Clomipramine 50-250 Sedation, Cardiovascular side effects, Dry mouth
Maprotiline 25-200 sedation, cardiovascular side effects, dry mouth
Mianserin 25-300 sedation, cardiovascular side effects, dry mouth
8.Other
Commonly used drugs Commonly used dose (mg/day) Common adverse reactions
Trazodone 25-200 Sedation, postural hypotension
St. John’s Wort 300 John’s Wort 300 Dizziness, fatigue
Dexedrine 1-2 Tremor, insomnia
Dactylan 2.5-37.5 Dryness, nausea
Agomelatine 12.5-50
(ii) Psychotherapy of depression
Psychotherapy can be used as an adjunctive treatment for depressive disorders. There are many schools of psychotherapy, and each psychiatrist may use a different approach. Psychotherapy can only be used as an adjunct to psychiatric treatment. Treatment with a psychiatrist who has received formal education and training is recommended.
Psychoanalysis.
Cognitive-behavioral.
Group group therapy.
(iii) Physical therapy for depression
1. Electroconvulsive shock
Electroconvulsive shock is a treatment method to control psychiatric symptoms by stimulating the brain with a brief and moderate amount of electric current, causing loss of consciousness, widespread cortical EEG emission and all-type convulsions. The current modified electroconvulsive therapy is to add intravenous anesthetics and muscle relaxants before treatment, when the patient’s convulsions are significantly reduced and no fear. It has been widely used because of wide indications, high safety and few complications.
Indications: For refractory depression, for patients with food refusal depression, for depression with strong suicidal and self-injurious behavior, and for depression with lignocaine.
Contraindications: intracranial occupying lesions; recent intracranial hemorrhage; persons with cardiac instability; hemorrhagic or unstable aneurysmal malformations; retinal detachment; pheochromocytoma; diseases causing risk of anesthesia.
Common adverse reactions: headache, nausea, vomiting. Prolonged apnea. Initially, patients will have memory loss, and memory will gradually recover.
2. Acupuncture: effective for patients with mild depression and can be used as an adjunctive treatment for patients with moderate to severe depression.
3. Transcranial magnetic stimulation: the latest invented treatment method, the therapeutic effect is yet to be verified.