Major Depressive Disorder (MDD) Treatment
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A Major Depressive Disorder (MDD) Treatment is a mood disorder treatment for MDD.
- Context:
- It can be assessed with an MDD Treatment Clinical Study.
- …
- Example(s):
- Counter-Example(s):
- See: Antidepressant, Cognitive Behavioral Therapy, Electroconvulsive Therapy.
References
2022
- https://www.ncbi.nlm.nih.gov/books/NBK559078/
- QUOTE: Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. Combination treatment, including both medications and psychotherapy, has been found to be more effective than either of these treatments alone.[8][9] Electroconvulsive therapy is found to be more efficacious than any other form of treatment for severe major depression.[10]
- FDA-approved medications for the treatment of MDD are as follows: All antidepressants are equally effective but differ in side-effect profiles.
- Selective serotonin reuptake inhibitors (SSRIs) include fluoxetine, sertraline, citalopram, escitalopram, paroxetine, and fluvoxamine. They are usually the first line of treatment and the most widely prescribed antidepressants.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) include venlafaxine, duloxetine, desvenlafaxine, levomilnacipran, and milnacipran. They are often used for depressed patients with comorbid pain disorders.
- Serotonin modulators are trazodone, vilazodone, and vortioxetine.
- Atypical antidepressants include bupropion and mirtazapine. They are often prescribed as monotherapy or as augmenting agents when patients develop sexual side-effects due to SSRIs or SNRIs.
- Tricyclic antidepressants (TCAs) are amitriptyline, imipramine, clomipramine, doxepin, nortriptyline, and desipramine.
- Monoamine oxidase inhibitors (MAOIs) available are tranylcypromine, phenelzine, selegiline, and isocarboxazid. MAOIs and TCAs are not commonly used due to the high incidence of side-effects and lethality in overdose.
- Other medications include mood-stabilizers, antipsychotics which may be added to enhance antidepressant effects.
- Psychotherapy.
- Cognitive-behavioral therapy
- Interpersonal therapy
- Electroconvulsive Therapy (ECT).
- Acute suicidality
- Severe depression during pregnancy
- Refusal to eat/drink
- Catatonia
- Severe psychosis
- Transcranial Magnetic Stimulation (TMS).
- FDA-approved for treatment-resistant/refractory depression; for patients who have failed at least one medication trial
- Vagus Nerve Stimulation (VNS)
- FDA-approved as a long-term adjunctive treatment for treatment-resistant depression; for patients who have failed at least 4 medication trials
- Esketamine.
- Nasal spray to be used in conjunction with an oral antidepressant in treatment-resistant depression; for patients who have failed other antidepressant medications