Current concepts in clinical therapeutics. Major affective disorders, part 1

S. G. Bryant, Candace Brown

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

The epidemiology, pathophysioslogy, diagnosis and clinical features, and treatment of unipolar (depressive) and bipolar (manic depressive) affective disorders are described. Disturbances of mood are the most common psychiatric disorders in adults, with 18-23% of women and 8-11% of men having at least one major depressive episode. Genetic factors are important in both depression and manic-depressive illness. Depression is characterized by a persistent dysphoric mood accompanied by feelings of sadness or hopelessness nearly every day for at least two weeks. The essential feature of a manic episode is an elevated, expansive, or irritable mood associated with symptoms such as hyperactivity and lack of judgment. Treatment involves nonpharmacologic and pharmacologic interventions. Psychotherapy in patients with depression is most useful in improving social functions, while antidepressant drugs reduce relapse rates. Electroconvulsive therapy is indicated in depressed patients at immediate risk of suicide or extreme incapacitation. Tricyclic antidepressants (amitriptyline, imipramine, doxepin, notriptyline, desipramine, trimipramine), second-generation antidepressants (maprotiline, amoxapine, trazodone, bupropion), monoamine-oxidase inhibitors (phenelzine, isocarboxazid, tranylcypromine, pargyline), and lithium are useful in treating patients with affective disorders. Tricyclic agents are the mainstay of treatment for depression; newer second-generation agents should be used in specific subgroups of patients. Lithium is the drug of choice for prophylaxis in bipolar patients, whereas combinations of lithium and tricyclic agents are useful during acute episodes of depression in bipolar patients. Major affective disorders occur commonly and require a careful balance of pharmacologic and pharmacologic interventions for proper therapy.

Original languageEnglish (US)
Pages (from-to)304-318
Number of pages15
JournalClinical Pharmacy
Volume5
Issue number4
StatePublished - Jan 1 1986
Externally publishedYes

Fingerprint

Mood Disorders
Lithium
Depression
Antidepressive Agents
Irritable Mood
Isocarboxazid
Amoxapine
Therapeutics
Trimipramine
Phenelzine
Doxepin
Maprotiline
Tranylcypromine
Trazodone
Pargyline
Bupropion
Desipramine
Amitriptyline
Electroconvulsive Therapy
Monoamine Oxidase Inhibitors

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

Current concepts in clinical therapeutics. Major affective disorders, part 1. / Bryant, S. G.; Brown, Candace.

In: Clinical Pharmacy, Vol. 5, No. 4, 01.01.1986, p. 304-318.

Research output: Contribution to journalReview article

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