2023-08-31 18:55:00
Expert shares keys to achieve the optimization of the pharmacological treatment of major depressive disorder.
By: Luisa Ochoa
August 31, 2023
The therapeutic management of major depression represents a challenge for professionals health mental because each case must be individualized according to the symptoms presented by the patients and their responses to certain pharmacological therapies.
According to Dr. Edgardo Prieto, president of the Puerto Rico Academy of Psychiatry, the traits of major depression and the severity of the patients’ symptoms directly influence the approach to the condition. Psychotherapy and pharmacotherapy are generally included in most cases.
Pharmacological therapy does not usually have immediate effects
Within pharmacotherapy there are multiple options known as antidepressants, which include serotonin reuptake inhibitors, atypical antidepressants, tricyclics, monoamine oxidase inhibitors and other drugs.
The expert mentions that these drugs do not usually generate sudden changes during the first days, so the therapy must be maintained for a long time to see its effects.
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“Antidepressant and anxiety medications are medications that do not work at the moment, you have to give them 14 to 21 days of continuous use to see if the patient is responding or not to treatment,” he said.
Precisely, when taking drugs without seeing an immediate effect or, in the opposite case, seeing a decrease in symptoms in a few weeks often causes patients to want to abandon treatment.
Leaving treatment earlier than prescribed may worsen major depression
“The problem with pictures of depression is that many times patients do not understand that even if they feel good, they have to continue with the treatment. The guidelines establish that treatment should be continued for one year.”
The process of fully complying with pharmacotherapy is part of the optimization of the treatment of major depression. In general, first the symptoms of the patients are identified, psychological and pharmacological treatment is started and a remission is sought.
“Symptom remission is when the patient is the same as they were before having the condition; that their level of functioning is adequate, that their level of anxiety is normal, and that those symptoms that have led to their disability have subsided.”
Most patients tend to go through several lines of medications until they find the one that best suits their needs. This process can be lengthy as the body adjusts to the side effects and achieves a decrease in depressive symptoms.
(See also: “Approximately 20% of the population have pictures of major depression“, Dr. Prieto)
Medical sources such as the Mayo Clinic report that hereditary traits influence how antidepressants affect them. In some cases, the results of genetic tests can offer clues regarding how the body might respond to a specific antidepressant.
“Treatments always have to be personalized. But to begin with, it’s important that patients understand that these sad episodes are leading them to not function properly and that’s where they need to seek help,” he concluded.
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