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27 - Psychopharmacology of mood disorders

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
William H. Coryell  and
John Geddes
Edited by
Peter Tyrer  and
Kenneth R. Silk
William H. Coryell
Affiliation:
Department of Psychiatry University of Iowa Iowa City, IA USA
John Geddes
Affiliation:
Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editorial note

As depression has been identified as the fourth leading cause of disease burden, accounting for 12% of total disability worldwide (Üstün et al., 2004), and because drug treatment is one of the most widely used, this chapter is a very important one. There are several messages that need to be disseminated from this chapter. Firstly, antidepressant drugs, despite many improvements over the years, remain drugs with many adverse effects, and selection of a drug is likely to be determined more by its adverse effect profile than by its efficacy rating. Next, depression is often combined with other disorders, and treatment must take into account the nature of these other conditions and the effect of drug treatment upon them. A third message is very important to clinicians; do not increase the dose of an antidepressant too readily. Response, particularly the full response, to an antidepressant is often delayed, and rushing to a high dose will only add to adverse effects at a time when the patient is not well prepared to deal with them. The treatment of bipolar disorder is associated with more controversy than depression alone, especially in the maintenance phase, and here there is a difference between recommendations in the United States and those of other countries, with much greater use of a typical antipsychotics and sodium valproate in the USA and more emphasis on lithium elsewhere, with bigger differences in the maintenance than acute phases of treatment.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 481 - 497
Publisher: Cambridge University Press
Print publication year: 2008

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  • Psychopharmacology of mood disorders
    • By William H. Coryell, Department of Psychiatry University of Iowa Iowa City, IA USA, John Geddes, Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.029
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  • Psychopharmacology of mood disorders
    • By William H. Coryell, Department of Psychiatry University of Iowa Iowa City, IA USA, John Geddes, Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.029
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  • Psychopharmacology of mood disorders
    • By William H. Coryell, Department of Psychiatry University of Iowa Iowa City, IA USA, John Geddes, Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.029
Available formats
×