Download e-book for kindle: An atlas of depression by David S Baldwin; Jon Birtwistle

By David S Baldwin; Jon Birtwistle

ISBN-10: 1850709424

ISBN-13: 9781850709428

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Example text

Carbamazepine can also exert teratogenic effects, possibly through causing iatrogenic folate deficiency. 44 summarizes the side-effects of the anticonvulsants. REFERENCES 1. Anderson IM, Nutt DJ, Deakin JFW. Evidence-based guidelines for treating depressive illness with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. J Psychopharmacol 2000;14:3–20 2. Baldwin DS, Rudge SE. Moclobemide – a reversible inhibitor of monoamine oxidase type A. Br J Hosp Med 1993;49:497–9 3.

Controlled trials have shown that mianserin is superior to placebo in the management of depression, and comparable to imipramine and clomipramine47. The longterm efficacy of mianserin is not proven. The main adverse effects of mianserin are drowsiness, dizziness, weight gain, dyspepsia and nausea. Cognitive impairment is more likely with mianserin than with SSRIs49. As with other tricyclics, mianserin increases the risk of seizures, and some patients may experience postural hypotension. The most serious adverse effect of mianserin is the lowering of the white cell count, while fatal agranulocytosis has been reported.

The situation is less clear for bipolar depression, where lengthening the duration of antidepressant treatment can sometimes precipitate hypomanic or manic episodes, or contribute to ‘cycle acceleration’, in which episodes of illness become more frequent over time. REFERENCES 1. Frank E, Prien RF, Jarret RB, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse and recurrence. Arch Gen Psychiatry 1991;48:851–5 2. Belsher G, Costello CG.

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An atlas of depression by David S Baldwin; Jon Birtwistle

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