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08 - Chapter 3 Depression and anxiety disorders

01 - Introduction to depression

Introduction to depression The Maudsley® Prescribing Guidelines in Psychiatry, Fifteenth Edition....

02 - Official guidance on the treatment of depress

Official guidance on the treatment of depression: a summary of the NICE guidelines1

03 - References

References 336 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Official guidance on ...

04 - Antidepressants general overview

Antidepressants – general overview

05 - Effectiveness

Effectiveness Depression and anxiety disorders CHAPTER 3 Antidepressants – general overview Effec...

06 - Onset of action

Onset of action

07 - Choice of antidepressant and relative adverse

Choice of antidepressant and relative adverse effects 338 The Maudsley® Prescribing Guidelines in...

08 - Drug interactions

Drug interactions

09 - Suicidality

Suicidality Depression and anxiety disorders CHAPTER 3 foods to cause hypertensive crisis and muc...

10 - Duration of treatment

Duration of treatment

100 - References

References 430 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References McCabe MP...

101 - SSRIs and bleeding

SSRIs and bleeding

102 - Gastrointestinal bleeding

Gastrointestinal bleeding Depression and anxiety disorders CHAPTER 3 Caution should be exercised ...

103 - Intracranialintracerebral haemorrhage

Intracranial/intracerebral haemorrhage

104 - Gynaecological and obstetric haemorrhage

Gynaecological and obstetric haemorrhage Depression and anxiety disorders CHAPTER 3 One database ...

105 - Abnormal vaginal bleeding

Abnormal vaginal bleeding

106 - Postpartum haemorrhage

Postpartum haemorrhage 436 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 were thre...

107 - Surgical and postoperative bleeding

Surgical and postoperative bleeding

108 - Alternatives to SSRIsSNRIs

Alternatives to SSRIs/SNRIs

109 - Overall

Overall Depression and anxiety disorders CHAPTER 3 A review of 13 studies found an increased odds...

11 - Next step treatments

Next-step treatments

110 - Summary

Summary

111 - References

References 438 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 5. Jiang HY, et al. U...

112 - St Johns wort

St John’s wort

113 - Evidence for St Johns wort in the treatment o

Evidence for St John’s wort in the treatment of depression 440 The Maudsley® Prescribing Guidelin...

114 - Adverse effects

Adverse effects

115 - Drug interactions

Drug interactions 442 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 People may reg...

116 - References

References Depression and anxiety disorders CHAPTER 3 26. Nicolussi S, et al. Clinical relevance ...

117 - Antidepressants relative adverse effects a r

Antidepressants: relative adverse effects – a rough guide 446 The Maudsley® Prescribing Guideline...

118 - Anxiety spectrum disorders

Anxiety spectrum disorders

119 - Benzodiazepines

Benzodiazepines

12 - Use of antidepressants in anxiety spectrum di

Use of antidepressants in anxiety spectrum disorders

120 - SSRIsSNRIs

SSRIs/SNRIs Depression and anxiety disorders CHAPTER 3 all drugs may be effective when standard d...

121 - Pregabalin

Pregabalin 448 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 overdose toxicity of ...

122 - Psychological approaches

Psychological approaches Depression and anxiety disorders CHAPTER 3 OCD (where there is moderate ...

123 - Summary of NICE guidelines for the treatment

Summary of NICE guidelines for the treatment of GAD, panic disorder and OCD Depression and anxiet...

124 - Panic disorder

Panic disorder

125 - GAD

GAD

126 - OCD (where there is moderate or severe functi

OCD (where there is moderate or severe functional impairment)

127 - References

References 456 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 19. Jakubovski E, et ...

128 - Benzodiazepines in the treatment of psychiatr

Benzodiazepines in the treatment of psychiatric disorders

129 - Anxiolytic effect

Anxiolytic effect

13 - References

References 340 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Toxicity in overdose ...

130 - Hypnotic effect

Hypnotic effect Depression and anxiety disorders CHAPTER 3 Use in depression Benzodiazepines are ...

131 - Use in depression

Use in depression

132 - Use in psychosis

Use in psychosis 462 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Epidemiological...

133 - Adverse effects

Adverse effects

134 - Drug interactions

Drug interactions Depression and anxiety disorders CHAPTER 3 15. Roehrs T, et al. Drug-­related s...

135 - References

References 464 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Benzodiazepines, z-­d...

136 - Benzodiazepines, z drugs and gabapentinoids d

Benzodiazepines, z-drugs and gabapentinoids: dependence, withdrawal effects and discontinuation 4...

137 - Withdrawal symptoms

Withdrawal symptoms Depression and anxiety disorders CHAPTER 3 patients with hepatic dysfunction,...

138 - Stopping benzodiazepines

Stopping benzodiazepines

139 - Dosage reduction (tapering)

Dosage reduction (tapering)

14 - Recognised minimum effective doses of antidep

Recognised minimum effective doses of antidepressants 342 The Maudsley® Prescribing Guidelines in...

140 - Direct taper or switching to diazepam

Direct taper or switching to diazepam?

141 - Pattern of tapering

Pattern of tapering 468 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Practical ap...

142 - Practical application of these principles

Practical application of these principles Depression and anxiety disorders CHAPTER 3 with smaller...

143 - Troubleshooting

Troubleshooting

144 - Reduction schedules

Reduction schedules 470 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 11. Horowitz...

145 - Tapering other drug classes

Tapering other drug classes

146 - References

References Depression and anxiety disorders CHAPTER 3 Benzodiazepines and disinhibition Unexpecte...

147 - Benzodiazepines and disinhibition

Benzodiazepines and disinhibition

148 - How common are disinhibitory reactions with b

How common are disinhibitory reactions with benzodiazepines? 472 The Maudsley® Prescribing Guidel...

149 - Who is at risk

Who is at risk?

15 - References

References Depression and anxiety disorders CHAPTER 3 References Furukawa TA, et al. Meta-­analy...

150 - What is the mechanism

What is the mechanism? Depression and anxiety disorders CHAPTER 3 References Schieveld JNM, et a...

151 - Subjective reports

Subjective reports

152 - Clinical implications

Clinical implications 474 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Premenstru...

153 - References

References Depression and anxiety disorders CHAPTER 3 If COCPs are ineffective, not tolerated, or...

16 - Drug treatment of depression

Drug treatment of depression 344 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Dru...

17 - Notes

Notes Depression and anxiety disorders CHAPTER 3 Notes ■ ■Tools such as the Montgomery–Asberg Dep...

18 - References

References 346 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 in treatment (British...

19 - Management of treatment resistant depression

Management of treatment-resistant depression – commonly used treatments 348 The Maudsley® Prescri...

20 - References

References Depression and anxiety disorders CHAPTER 3 References Dunner DL, et al. Prospective, ...

21 - Management of treatment resistant depression

Management of treatment-resistant depression – other well- supported treatments Depression and an...

22 - References

References 352 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Marcanton...

23 - Treatment resistant depression other reporte

Treatment-resistant depression – other reported treatments Depression and anxiety disorders CHAPT...

24 - References

References 354 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Gonçalves...

25 - Ketamine

Ketamine

26 - Background

Background

27 - Mechanism

Mechanism

28 - Route of administration

Route of administration Depression and anxiety disorders CHAPTER 3 Ketamine Background Over the p...

29 - Adverse effects

Adverse effects 358 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 doses tested, in...

30 - References

References 360 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Berman RM...

31 - Psychotic depression

Psychotic depression

32 - Acute treatment

Acute treatment 362 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Psychotic depres...

33 - Ketamine formulations

Ketamine formulations

34 - ECT

ECT

35 - Maintenance treatment

Maintenance treatment Depression and anxiety disorders CHAPTER 3 Ketamine formulations Many of th...

36 - Other treatments

Other treatments

37 - Summary

Summary

38 - References

References 364 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 for 4–6 months after ...

39 - Switching antidepressants

Switching antidepressants

40 - General guidelines

General guidelines 366 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Switching ant...

41 - References

References 372 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Horowitz ...

42 - Antidepressant withdrawal symptoms

Antidepressant withdrawal symptoms

43 - Signs and symptoms

Signs and symptoms

44 - Incidence and severity

Incidence and severity Depression and anxiety disorders CHAPTER 3 Antidepressant withdrawal sympt...

45 - Time course

Time course 374 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Time course The onse...

46 - Clinical relevance14,15

Clinical relevance14,15

47 - Who is at risk10,1416,18

Who is at risk?10,14–16,18

48 - How to avoid1416,18

How to avoid14–16,18 Depression and anxiety disorders CHAPTER 3 Clinical relevance14,15 The sympt...

49 - How to treat1416,23

How to treat14–16,23

50 - References

References 376 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 difficult to stop.13 ...

51 - Stopping antidepressants

Stopping antidepressants

52 - Rate of tapering

Rate of tapering 378 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Stopping antide...

53 - Pattern of tapering

Pattern of tapering Depression and anxiety disorders CHAPTER 3 Pattern of tapering Although reduc...

54 - Practical application of tapering

Practical application of tapering 380 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER ...

55 - Troubleshooting

Troubleshooting Depression and anxiety disorders CHAPTER 3 A cautious initial rate of reduction i...

56 - References

References 382 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Unfortunately, most c...

57 - Electroconvulsive therapy and psychotropic dr

Electroconvulsive therapy and psychotropic drugs 384 The Maudsley® Prescribing Guidelines in Psyc...

58 - References

References 386 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Pluijms E...

59 - Psychostimulants in depression

Psychostimulants in depression 388 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 P...

60 - References

References Depression and anxiety disorders CHAPTER 3 References Satel SL, et al. Stimulants in ...

61 - Post stroke depression

Post-stroke depression

62 - Prophylaxis of post stroke depression

Prophylaxis of post-stroke depression

63 - Treatment of post stroke depression

Treatment of post-stroke depression Depression and anxiety disorders CHAPTER 3 Post-­stroke depre...

64 - References

References 394 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 with a heightened ris...

65 - Antidepressant prophylaxis

Antidepressant prophylaxis

66 - After first episode

After first episode

67 - Recurrent depression

Recurrent depression Depression and anxiety disorders CHAPTER 3 Antidepressant prophylaxis After ...

68 - Discontinuation of medium and long term antid

Discontinuation of medium- and long-term antidepressants 398 The Maudsley® Prescribing Guidelines...

69 - Dose for prophylaxis

Dose for prophylaxis

70 - References

References Depression and anxiety disorders CHAPTER 3 treatment or to have antidepressants slowly...

71 - Drug interactions with antidepressants

Drug interactions with antidepressants

72 - Pharmacokinetic interactions

Pharmacokinetic interactions Depression and anxiety disorders CHAPTER 3 Drug interactions with an...

73 - Pharmacodynamic interactions

Pharmacodynamic interactions 402 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Pha...

74 - 16. References

16. References Depression and anxiety disorders CHAPTER 3 (lumateperone and ziprasidone) and drug...

75 - Cardiac effects of antidepressants summary

Cardiac effects of antidepressants – summary

76 - References

References Depression and anxiety disorders CHAPTER 3 SSRIs are generally recommended in cardiac ...

77 - Antidepressant induced arrhythmia

Antidepressant-induced arrhythmia Depression and anxiety disorders CHAPTER 3 Antidepressant-­indu...

78 - Use in at risk patients

Use in at-risk patients

79 - Relative cardiotoxicity

Relative cardiotoxicity 412 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Use in a...

80 - Summary

Summary

81 - References

References Depression and anxiety disorders CHAPTER 3 Summary ■ ■Tricyclics (but not lofepramine)...

82 - Antidepressant induced hyponatraemia

Antidepressant-induced hyponatraemia

83 - Which antidepressants

Which antidepressants?

84 - Database studies

Database studies 416 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Antidepressant-...

85 - Monitoring1,27,28

Monitoring1,27,28

86 - Treatment28

Treatment28

87 - Restarting treatment

Restarting treatment

88 - Other prescribed drugs

Other prescribed drugs 418 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Treatment...

89 - References

References Depression and anxiety disorders CHAPTER 3 10. Movig KL, et  al. Association between a...

90 - Antidepressants and hyperprolactinaemia

Antidepressants and hyperprolactinaemia

91 - References

References Depression and anxiety disorders CHAPTER 3 References Emiliano AB, et  al. From galac...

92 - Antidepressants and diabetes mellitus

Antidepressants and diabetes mellitus

93 - Depression and diabetes

Depression and diabetes

94 - Recommendations

Recommendations 424 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Recommendations ...

95 - References

References Depression and anxiety disorders CHAPTER 3 12. Briscoe VJ, et al. Effects of a selecti...

96 - Antidepressants and sexual dysfunction

Antidepressants and sexual dysfunction

97 - Effects of depression

Effects of depression 426 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Antidepres...

98 - Effects of antidepressant drugs

Effects of antidepressant drugs 428 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 ...

99 - Post SSRI sexual dysfunction

Post-SSRI sexual dysfunction