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Titolo:
Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment: A survey of clinicians
Autore:
Mischoulon, D; Nierenberg, AA; Kizilbash, L; Rosenbaum, JF; Fava, M;
Indirizzi:
Massachusetts Gen Hosp, Depress Clin & Res Program, Dept Psychiat, Boston,MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Psychiat, Boston,MA 02114 USA Massachusetts Gen Hosp, Outpatient Psychiat Dept, Dept Psychiat, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Psychiat, Boston, MA 02114 USA
Titolo Testata:
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE
fascicolo: 5, volume: 45, anno: 2000,
pagine: 476 - 481
SICI:
0706-7437(200006)45:5<476:SFMDRT>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
BUSPIRONE AUGMENTATION; RESISTANT DEPRESSION; ANTIDEPRESSANT LATENCY; AUTORECEPTOR BLOCKADE; MAJOR DEPRESSION; FLUOXETINE; LITHIUM; PSYCHIATRISTS; PAROXETINE; BUPROPION;
Keywords:
treatment-resistant depression; refractory depression; selective serotonin reuptake inhibitors; bupropion; augmentation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Mischoulon, D Massachusetts Gen Hosp, Depress Clin & Res Program, Dept Psychiat, WAC-812,15 Parkman St, Boston, MA 02114 USA Massachusetts Gen Hosp WAC-812,15 Parkman St Boston MA USA 02114
Citazione:
D. Mischoulon et al., "Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment: A survey of clinicians", CAN J PSY, 45(5), 2000, pp. 476-481

Abstract

Objective: To examine treatment practices in cases where selective serotonin reuptake inhibitors (SSRIs) are ineffective. Methods: We surveyed 801 clinicians (including 630 psychiatrists) attending the Massachusetts General Hospital's annual psychopharmacology review course. Clinicians were presented with a vignette about a patient with depression who had, responded partially to an SSRI and were asked to choose among various strategies available to manage this patient. Results: Of those surveyed, 466 clinicians had been in practice a mean of 16.6 years (SD 10.7). Not all clinicians chose to answer every question. Among 455 respondents, 84% (n = 382) chose to increase the dose of the SSRI, 10% (n = 47) chose augmentation or combination, and 7% (n = 31) opted for switching agents. When asked to switch to another agent, 448 responded of whom 52% (n = 235) chose a newer antidepressant, 34% (n = 152) chose another SSRI, 10% (n = 44) chose a tricyclic antidepressant (TCA), 2% (n = 8) chosea serotonin norepinephrine reuptake inhibitor (SNRI), 1% (n = 5) chose a monoamine oxidase inhibitor (MAOI), and 1% (n = 4) chose an undefined "other" agent. Among 445 respondents, bupropion was the most widely chosen augmenting agent (30%, n = 134),followed by lithium (22%, n = 98). West coast and Canadian clinicians preferred to switch to another SSRI rather than to a newer antidepressant. Canadian clinicians preferred lithium to bupropion astheir first-choice augmenting agent, as did clinicians from academic settings. Clinicians from community, individual practice, or group settings favoured bupropion. More experienced clinicians preferred bupropion as a first-choice augmenter, whereas less experienced ones showed a slight preference for lithium. Canadian clinicians were more likely to use MAOIs as second-line agents. Conclusions: Clinicians in this sample often followed strategies differentfrom those recommended in the literature. Bupropion may have an important role in augmentating treatment with SSRIs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 13:51:45