Depression symptoms

Disulfiram produces a variety of adverse effects, which commonly include drowsiness, lethargy, and fatigue (Chick 1999). Other more serious adverse effects, such as optic neuritis, peripheral neuropathy, and hepatotoxicity, are rare. Psychiatric effects of disulfiram are also uncommon. They probably occur only at higher dosages of the drug and may result from the inhibition by disulfiram of a variety of enzymes in addition to ALDH. Included among the enzymes inhibited by disulfiram is dopamine P-hydroxylase, inhibition of which increases dopamine levels, which in turn can exacerbate psychotic symptoms in patients with schizophrenia and occasionally may result in psychotic or depressive symptoms in patients without schizophrenia. 

Dean AJ, Bell J, Mascord DJ, et al A randomized, controlled trial of fluoxetine in methadone maintenance patients with depressive symptoms. J Affect Disord 72 ... 

Bovasso GB Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry... 

Sevarino KA, Oliveto A, Kosten TR Neurobiological adaptations to psychostimulants and opiates as a basis of treatment development. Ann N Y Acad Sci 909 51 —87,2000 Silberman EK, Reus VI, Jimerson DC, et al Heterogeneity of amphetamine response in depressed patients. AmJ Psychiatry 138 1302—1307, 1981 Sofuoglu M, Brown S, Babb DA, et al Depressive symptoms modulate the subjective and physiological response to cocaine in humans. Drug Alcohol Depend 63 131-137, 2001... 

Uslaner J, Kalechstein A, Richter T, et al Association of depressive symptoms during abstinence with the subjective high produced by cocaine. Am J Psychiatry 156 1444-1446, 1999... 

Persons with depressive symptoms or major depression also have high rates of smoking (40%-60% prevalence), and depression appears to be a predictor of... 

People with schizophrenia may appear uncooperative, suspicious, hostile, anxious, or aggressive due to their misinterpretation of reality. They may have poor hygiene and appear unkempt, as psychosis, as well as depressive symptoms, may lead... 

The diagnosis of a major depressive episode requires the presence of a certain number of depressive symptoms (five) for a minimum specified duration (2 weeks) that cause clinically significant effects (Table 35—l).3... 

The obvious goal of therapy for the depressed patient is the resolution of depressive symptoms and a return to euthymia. Once symptoms have resolved, then the purpose of ongoing therapy is to prevent relapse and recurrence of depressive symptoms. One extremely important outcome in the treatment of MDD is the prevention of suicidal attempts. Other essential outcomes include improvement of the patient s quality of life, normalization of functioning in areas such as work and relationships, avoidance or minimization of adverse effects, and reduction of health care costs.15... 

Obtain a thorough history of prescription, nonprescription, natural, and illicit drug product use. Rule out medications or medical disorders that may cause or mimic depressive symptoms. 

I and depressive symptoms. Hypomanic symptoms include inflated self-esteem or grandiosity (non-delusional), decreased need for sleep, pressure of speech, flight of ideas, distractibility, and increased involvement in goal-directed activities, not causing severe impairment in social or occupational functioning or requiring hospitalization. Psychotic features are not found in cyclothymic disorder.1... 

O The goals of therapy for GAD are to acutely reduce the severity and duration of anxiety symptoms and restore overall functioning. The long-term goal in GAD is to achieve and maintain remission. With a positive response to treatment, patients with GAD and comorbid depression should have minimal depressive symptoms. 

Benzodiazepines are used commonly in SAD however, there are limited data supporting their use. Clonazepam has been effective for social anxiety, fear, and phobic avoidance, and it reduced social and work disability during acute treatment.58 Long-term treatment is not desirable for many SAD patients owing to the risk of withdrawal and difficulty with discontinuation, cognitive side effects, and lack of effect on depressive symptoms. Benzodiazepines may be useful for acute relief of physiologic symptoms of anxiety when used concomitantly with antidepressants or psychotherapy. Benzodiazepines are contraindicated in SAD patients with alcohol or substance abuse or history of such. 

Another study with citalopram evaluated its efficacy in the treatment of social anxiety disorder along with co-morbid major depression (Schneier etal., 2003). The outpatients (n= 21) were predominantly Hispanic (76%) and from New York. Response rates for the intent-to-treat sample were 66.7% for social anxiety disorder and 76.2% for major depression. Only one subject was known to have withdrawn secondary to severe side effects. The mean dose of the medication was 37.6 mg/day and there was no placebo control. The depressive symptoms tended to improve... 

The sleep-inducing effect of some antidepressants has been used as an additive strategy in depressed patients with complaints of insomnia to negate the side effects of BZDs that could be confused with worsening depressive symptoms, including asthenia, diurnal sedation, and concentration and memory problems. 

Goodman E and Capitman J. (2000). Depressive symptoms and cigarette smoking among teens. Pediatrics, 196, 748-755. 

The American Psychiatric Association diagnostic criteria are listed in Table 19.1. Table 19.2 describes the clinical features and Table 19.3 lists medical illnesses and drugs that can cause depressive symptoms. 

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