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TREATMENT
OPTIONS FOR DEPRESSION
American Psychiatric Association advises that more than 80% of persons
suffering from depression can find relief with antidepressant medication,
psychotherapy or a combination of both.
The major types of treatment for depression are:
| • |
Antidepressant medication |
| • |
Psychotherapy (talk therapy) |
| • |
Antidepressant
medication combined with psychotherapy |
| • |
Other
treatments, including electroconvulsive therapy ( ECT) and light
therapy |
IF YOU ARE ALREADY IN TREATMENT-STAY THE COURSE
Adherence to your treatment plan is essential to your potential
to feeling better and gaining better control of your depression.
Adherence is defined as following prescribed activities, such as
keeping appointments, taking medication, and completing assignments.
Involving your family in your treatment plan increases the likelihood
of your success.
Once you begin treatment, stay with it. There are two frequent causes
of not continuing with your treatment plan 1) medication early onset
of side effects. Stay with your treatment plan and many times side
effects may diminish. Or inform your doctor you are having problems
with the treatment plan and/or medication and the doctor will work
with you to achieve a more acceptable program. With some medications
you may feel better in a brief period of time and believe you are
'cured'. The reason you may be feeling is better is because you
are having a positive response and the medication is working well
for you. Stay with your treatment plan and your doctor will help
you decide when it is best to discontinue, reduce or change your
medication.
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TREATMENT
WITH MEDICATION
There are many new highly effective medications for the treatment
of depression. These medications have far fewer side effects than
their predecessors. They include selective serotonin reuptake Inhibitors,
more commonly known as SSRIs (including Prozac, Paxil, Zoloft, and
Celexa) and dopamine reuptake inhibitors (DRIs) such as Wellbutrin.
Tricyclic Antidepressants, known as TCAs, (which include Sinequan
and Elavi) and monoamine oxidase inhibitors (MAOIs such as Marplan)
are used less frequently than in the past because of the lower incidence
of side effects with SSRIs and DRIs. SSRIs and DRIs work by regulating
the uptake and reabsorption of neurotransmitters at the nerve endings.
Regardless of the antidepressant prescribed report any side effects
to your doctor. Make sure your physician is aware of any other medications
that you are taking. This is especially important if you have any
other medical conditions requiring medication.
Here are some tips specifically about medications:
| • |
Typically
maximum benefit from all antidepressants can be delayed for
3 - 5 weeks from initiation of medication. |
| • |
Medicines need to be taken from six -
nine months to many years. |
| • |
Never
stop taking your medicine or change the dose without first consulting
your doctor. |
| • |
Lack of adequate response is most frequently from inadequate
dose or inadequate time on medication. Talk to your doctor if
you don't respond to medication in the period of time the doctor
said you should. |
| • |
Get clear instructions and information
regarding the treatment regimen from your doctor. |
| • |
Take your medication as prescribed and |
| • |
Report any problems to your doctor
| • |
Don't
skip doses. |
| • |
Take
medication the same time everyday. |
| • |
Get
refills as prescribed and don't let time lapse between
refills. |
|
| • |
If you are having a problem getting your prescriptions filled,
let the doctor know. |
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NUTRITION
There is no special diet or nutrition plan for depression.
However, you should make nutritious food choices. Depression itself
may cause anorexia or overeating. Antidepressant medications impact
nutrition and can produce weight gain. Since many patients with depression
have other medical conditions, you must make sure that you follow
the therapeutic diet related to any other illnesses.
Special
note: Patients taking MAO inhibitors, a class of antidepressants,
should be aware of the serious adverse affects that can occur should
the patient eat foods high in tyramines concommitant with MAO inhibitors.
These include abnormally elevated blood pressure, intracranial hemorrhage
and death. The severity of these possible interactions warrants a
referral to a nutritionist. In general, persons taking MAO inhibitors
should avoid all protein-rich foods that have been aged, dried, fermented,
pickled, smoked, or cured.
Dry mouth is a side effect of some
antidepressants that impacts the patient's nutrition. Some tips for
combating dry mouth:
| • |
Snack on sugarless sour hard candies to help stimulate saliva
production. |
| • |
Chew sugar free gum or ice chips. |
| • |
Use
lip balm to keep lips moist. |
| • |
Ask the physician about prescribing saliva substitutes, such
as: Mouth Kote, Oral Balance, MoiStir, Orex, Salivant and Kerolube.
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