Ensure dosage prescribed is therapeutic

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Reference no: EM133747285

Summarize: scertain that diagnosis is correct and that patient is compliant with therapy • Ensure dosage prescribed is therapeutic; measure plasma level; ensure there has been an adequate trial period, i.e., up to 6 weeks at a reasonable dose • Regular, systematic assessment of the patient's response to drug therapy, with the use of measurement tools for symptoms, adverse effects, ar patient adherence is useful to guide future clinical decisions • Concurrent medical or psychiatric illness, e.g., hypothyroidism, OCD • Personality disorders lead to poor outcome; however, depression may evoke personality problems that may disappear when the depression alleviated • Drug abuse may make management difficult (e.g., cocaine); see CANMAT recommendations • Psychosocial factors may affect response • Low folate levels associated with lack of remission, response and relapse • Concurrent prescription drugs may interfere with efficacy (e.g., calcium channel blockers) • Metabolic inducers (eg., carbamazepine) or inhibitors (e.g., erythromycin) will affect plasma level of antidepressant • Genetic variants • Switching from one SSRI to another can enhance response in previously nonresponsive patients • 20-25% remission rate when switching from SSRI to another class of antidepressant or a different SSRI after failure of first SSRI (STAR'D studies) • Switching between

Reference no: EM133747285

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