55% of antidepressant patients achieve complete remission for eight weeks treatment

Created on January 13, 2018 at 4:48 pm by admin

In case you have not managed to solve the problem of depressioneither alone or with the help of a psychologist, you will have to turn to a psychiatrist. Therefore, it is important to know what medications you can describe and how they work. This is really useful information!

I will now describe to you a case from my practice and how TCP information about him helped him to participate in his health and seek informed consent from the psychiatrist. To find out about my client’s problem, I applied the following method. I applied psychodiagnostics with the best clinical and personality test MMPI – 2 / Minnesota Multifactor Personality Questionnaire /.

I found that TP was suffering from severe depression and had thoughts of suicide. Having understood these thoughts, I immediately directed him to a psychiatrist, because in the presence of suicidal thoughts, this is a must. I have researched some of the depression drugs and collected the information below.

Depression may be classified according to its severity, and then it is divided into mild, moderate and severe, with partial or complete remission. The most severe form of the depressed (and manic) episode is psychotic depression and psychotic mania, which are characterized by the presence of psychotic symptoms such as delusions and hallucinations. Thus, a separate category of psychotic mood disorder emerges   It remains a chronic condition in which many patients have recurrent episodes.

The incidence of remission / time during which symptoms of the disease do not occur (achieved with treatment with various antidepressants) varies widely. The rate of remission is higher for antidepressants such as substances that block certain physiological processes of the opposite effect of serotonin and noradrenaline than for older substances that suppress or stop different processes in the body of the opposite effect.

My client asked me and told me that his doctor had enrolled venlafaxine. I searched for this medicine and found that 40% to 55% of venlafaxine (immediate and prolonged-release) formulations reported remission after eight weeks of treatment.

However, my studies have shown that approximately one third of patients with depression fail to fully respond to antidepressant medication, which is conducted in adequate doses and of sufficient duration.

In treatment with currently available antidepressants, the condition of patients does not satisfy complete syndromes / the symptom is a combination of signs associated with the disease state and occurring simultaneously. Typical of syndromes is that when one or a part of their symptoms is detected, others can easily be detected, but at the same time there is no complete relief of symptoms.

I also looked for other antidepressants, and the results of one study showed that only a quarter of patients (initially treated with citalopram and who did not achieve remission or unable to tolerate the drug) achieved remission of symptoms in secondary treatment with bupropion, sertraline or venlafaxine.

These results also highlight the differences that exist between findings from clinical trials and those from clinical practice, with a “statistically significant” statistically significant lower incidence of remission.

While the limitations on current medications may include limited effectiveness and / or insufficient cooperative treatment, acknowledgment and acceptance of differences undoubtedly support the need to refine current strategies for treating depression.

Moreover, although long-term antidepressant treatment can reduce the risk of returning symptoms after a period of improvement or a new episode, this is only achieved in a small proportion of patients in clinical practice, partly due to other symptoms and side effects such as disturbances sleep and tiredness, sexual problems and weight gain.

The problem facing you and the psychiatrist is the demand for an antidepressant that will enable you to achieve fuller remission. You can discuss this with your doctor and find a solution together because you are becoming an active participant in the fight against depression, and this is also a therapeutic approach.

Unfortunately, in individuals treated for depression, residual symptoms are common and are associated with an increased risk of their return and inadequate psychosocial functioning.

These important symptoms of depression may be even more important as it is difficult to distinguish from treatment-emergent side effects such as anxiety, sleep disturbance, drowsiness and fatigue and cognitive and executive dysfunction often caused by currently used medications.

Based on the results of my study, residual symptoms during remission were a common phenomenon in depression and were observed in 32% of patients. They have a relationship with the severity of the initial disease. Remaining symptoms during remission are also a powerful prognostic parameter for subsequent symptoms, seen in 76% of patients with residual symptoms, and in 25% of those with no such symptoms.

Furthermore, residual symptoms significantly affect patient function / occupational function and subjective stress in their relationship with others. / RTI & gt;

To some extent, residual symptoms are present in treatment with all antidepressants. They are so common that antidepressants need to be combined with additional medication.

Sleep disturbances and wakefulness can cause a worsening of the prognosis. Once a remission has been achieved, they can have a significant value. These are the so-called cyclic rhythms.

Regardless of treatment, patients with a depressive episode often experience sleeping difficulties, reduced sleep duration, frequent night wake.

The results of another study showed that among the 215 depressed patients treated with fluoxetine, rhythm sleep and wakefulness syndromes combining sleep-related symptoms, somnolence and fatigue were the most common and important residual symptoms.

The presence of similar residual symptoms has led to the increased use of various additional medications such as anxiolytics, benzodiazepines and psychostimulants, in order to compensate for the narrow spectrum of antidepressant efficacy.

Studies have linked partial remission with a statistically significant increased risk of returning symptoms. One recent study reported that 91.4% of patients with residual symptoms after partial remission had a subsequent early symptom recovery compared to 51.3% of those with residual symptoms. During repetitive episodes, the severity of depressive symptoms is greater than the first episodes.

Remedies of daytime alertness are often observed in remission patients. They appear to be residual symptoms. Indeed, drowsiness and drowsiness are important residual symptoms in depressed patients treated with antidepressants, with almost 40% of those who responded to treatment.

These debilitating residual symptoms require additional treatment, and based on this information, my client discussed this with her physician, thus finding the most appropriate drug for him.

In remission patients receiving currently available antidepressants, apathy, cognitive and executive disorder are often found both as residual symptoms and as side effects of medication.

Cyclical rhythms are an adaptive phenomenon to periodic changes in daytime occurring in the surrounding environment, the most important of which is the light / dark cycle.

Cyclic rhythms are characterized by a constant period of about 24 hours and are internally defined. They are the basis of various biological, physiological and behavioral changes.

Many believe that depression is due to a mixture of genetic vulnerability, environmental factors, the impact of traumatic life events and somatic diseases. But until recently, there was no integrated approach explaining how these parameters triggered depression.

Today, the cyclical approach to depression provides insight into explaining depression. Exhaustive data suggest that all of these individual dimensions as well as the size of the environment cause changes in biological, physiological, and behavioral cyclical rhythms, which in turn may be at the root of the development of mood disorders such as: major depression, bipolar disorder and seasonal affective disorder.

Indeed, depression is intimately linked to changes in cyclical rhythms of biological, symptomatic (e.g., mood swings and symptoms associated with the sleep and wakefulness / social cycle).

Moreover, recent genetic, molecular and behavioral studies reveal the existence of individual genes that make up the “clock” for mood regulation. In addition, the important functions of these brain genes and mood-related hormones are obvious.

Given the lack of organization of cyclical rhythms for depression, the recovery of altered cyclical rhythms in mood disorders reveals a new and promising potential for better remission of patients with depression.

Restoring cyclical rhythms in depressed patients can result in a unique alleviation of all major symptoms of depression, which broadens the spectrum of antidepressant efficacy and allows long-term maintenance of treatment. Thus, antidepressants respond to the challenge of achieving better remission of symptoms.

Thus, the recovery of cyclical rhythms in depression represents an entirely new and promising therapeutic approach to this disease.

The idea of ​​cycling for depressive states has a key role to play in the cause and cure of this disease. This new understanding of depression leads to the hypothesis that restoring cyclical rhythms in depressed patients may have antidepressant potential.

Therefore, cyclic rhythm recovery drugs can have a powerful and broad anti-depressant potential to relieve the main symptoms of depression, including depressed mood, lack of pleasure in doing something or doing it, sleep disturbances.

One new drug – Agomelatin – is under investigation. This is an antidepressant to treat depression. It represents a new step forward in the treatment of depression.

In recent years, the relationship between depressive states and cyclic rhythm disorders has been increasingly investigated.

At the symptomatic level, most major symptoms of depression, such as depressed mood, lack of pleasure in doing something, or making me anxious, anxiety, excessive daytime depression, and sleep disturbances have been described in terms of cyclical rhythms.

This opens the way for a better understanding of depression and provides a new interpretation of clinical observations, such as typical variations of depressed mood. The depressed mood a bit improves throughout the day is the result of disturbing the normal cyclical mood rhythms. These results are constantly repeated in many clinical trials.

In addition, many of the other major symptoms, the most obvious of which are the symptoms associated with the sleep / wake cycle, were associated with morbid cyclic rhythms. Sleep disturbances and daytime falls are indeed very common symptoms in depressive states, as 80% of depressed patients report their presence in a clinical setting.

All these symptoms of depression are very important because they are considered as major residual symptoms in patients treated with currently available antidepressants. These residual symptoms not only significantly interfere with the recovery and functioning of patients, but are also a predictor of inadequate treatment. In the long run, they are also a prognosis for a recurrence of the symptoms.

The current limitations of therapy with available antidepressants and the ongoing efforts of researchers have increased the demand for a new and effective approach to the treatment of depression based on the recovery of cyclical rhythms in depressed patients. This is the beginning of new searches in the field of depression treatment and reveals new therapeutic prospects for fuller and long-term remission.

Therefore, it is important to discuss with your psychiatrist the possible medications that occur during depression and find the most suitable for you together.

If you fall into those nearly 50% of depressed patients who are treated with antidepressants and can not be cured, it is necessary to combine them with psychotherapy and / or herbs. Information about herbs that you can take to treat depression will be read in the next article.

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Author: Nelly Pencheva

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