Recent developments in the acute somatic treatment of major depression.
The subtypes of major depression are reviewed, and a decision tree for the acute somatic treatment of major depression, including delusional and nondelusional depression, is presented. Considerations in clinicians' decisions about initiation and selection of acute somatic treatment for patients with major depression are then discussed. Current somatic therapies for nondelusional depression are described, with emphasis on the mechanisms of action of the drugs employed, the relationship between mechanism of action and side effect profile, and the selection of a drug on the basis of its side effect profile. The three current strategies for the treatment of delusional depression--electroconvulsive therapy, the combination of an antidepressant and an antipsychotic agent, and amoxapine alone--are then reviewed.
Department of Psychiatry, Harvard Medical School, Boston, Mass.
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Schatzberg
D000657:Amoxapine / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003663:Decision Trees; D003702:Delusions / Q000145:classification / Q000188:drug therapy / Q000628:therapy; D003866:Depressive Disorder / Q000145:classification / Q000188:drug therapy / Q000628:therapy*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D006801:Humans; D012720:Severity of Illness Index
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000657:Amoxapine