Depression reactive

These data show that for three psychotic disorders (schizophrenia, bipolar disorder and unipolar depression) the genetic contribution is over 50% but for reactive depression (in response to a traumatic life event ) and tuberculosis, an infectious disease caused by a species of Mycobacterium, environmental factors account for over 90% of the variance. 

A 27- year-old male presents with reactive depression following the accidental death of a close relative. A tricyclic antidepressant is chosen to control his depression. Which adverse effect would not be of concern ... 

Causes of psychogenic ED include malaise, reactive depression or performance anxiety, sedation, Alzheimer s disease, hypothyroidism, and mental disorders. Patients with psychogenic ED generally have a higher response rate to interventions than patients with organic ED. 

MAO inhibitors are used in treating severe endogenous, exogenous, and reactive depressions that do not react to treatment with tricyclic antidepressants, as well as for controlling depressive phases in manic-depressive psychoses. 

Amoxapine Relief of depressive symptoms in patients with neurotic or reactive depressive disorders and endogenous and psychotic depression depression accompanied by anxiety or agitation. 

A considerable number of tricyclic antidepressants have been developed in the past, although with slight differences in their pharmacological activities, ah with similar efficacy. They are primarily indicated for the treatment of endogenous depression. However this does not exclude efficacy in patients in whom the depression is associated with organic disease or in patients with reactive depression or depression combined with anxiety. They may also benefit patients during the depressive phase of manic-depressive disorder. For some also efficacy has been claimed in panic states, phobic disorders, and in obsessive-compulsive disorders. 

These agents are effective in the treatment of a variety of depressive disorders like endogenous depression, depression associated with organic disease, reactive depression and depression combined with... 

Viewed as a whole, this investigation supports the view that tricyclic antidepressants are particularly effective in cases of endogenous depression, whereas psychotherapy, possibly in conjunction with drug therapy, constitutes the best solution in cases of situative depression (which would probably be termed reactive depression in the terminology used hitherto). It is interesting to note that the combination of drug therapy with psychotherapy provided additional benefit in patients with endogenous depression. It must, however, be stated that this final conclusion is only based on a fairly small subsample. 

Reactive depressive syndromes, including adjustment disorders... 

Reactive depression that results from knowledge of seropositivity or the onset of serious physical symptoms is best managed by supportive therapy and, if necessary, by antidepressants. The drug of choice is an agent with low anticholinergic potency (e.g., sertraline, trazodone), started more slowly and maintained at a lower level than in non-AIDS patients. 

The discovery that drugs elevating extracellular levels of noradrenaline and/or serotonin have analgesic potential was circumstantial. In I960, Paoli et al. reported that during an attempt to treat reactive depression in chronic pain patients with the tricyclic antidepressant imipramine they observed an improvement of the patients neuralgic pain. Subsequently, it became well established that antidepressant drugs can improve both depression and chronic pain states. 

Depressive disorders are the most prevalent of psychiatric illnesses, occurring more often among women (16%) than among men (8%). Depression, a recurrent but self-limiting disorder, is classified as (1) exogenous or reactive depression or as (2) endogenous depression. Depression is further... 

Reactive depression as (overshooting) reaction to psychic insults or somatic illness... 

Larsen JK, Holm P, Hoyer E, MejUiede A, Mikkelsen PL, Olesen A, Schaumburg E. Moclobemide and clomipramine in reactive depression. A placebo-controlled randomized clinical trial. Acta Psychiatr Scand 1989 79(6) 530-6. 

In very similar ways, in numerous studies the biochemistry of people with reactive depressions has been shown to be markedly altered. For example, emotionally healthy individuals without a personal or family history of depression who encounter major psychosocial stressors (especially losses) often become depressed. Presumably such people are not especially at risk (biologically or psychologically) for depression, but nonetheless they become depressed in response to significant stressful events. Further, in the course of their reaction, some patients develop not... 

Illnesses and conditions that do not directly affect the CNS, but can lead to secondary (reactive) emotional responses. These conditions are generally recognized and reported by the patient. Examples are a person who develops a serious reactive depression after sustaining a spinal cord injury and paralysis and an individual who is diagnosed with glaucoma and may be facing blindness. 

Classic reactive depressions (sometimes referred to as psychological depressions) can range in intensity from mild or moderate (for example, adjustment disorders with depressed mood) to severe (major depression). These disorders occur in response to identifiable psychosocial stressors. These stressors may be acute and intense (such as loss of a loved one), insidious (as in the case of a gradual deterioration in the quality of marital relationship), or in the distant past (for example, the emotions experienced by a survivor of child abuse who in adulthood begins to recall long-forgotten abusive events). 

In its pure form, reactive depression can present with severe levels of symptomatology, yet basic physical functions (sleep, energy levels, and so on) are relatively unaffected. Note that many reactive depressions do take on biological features, as will be described below, but the pure reactive disorder noted here is seen without major physiological symptoms. 

Is it a type of depression that typically is not responsive to medication treatment (such as psychological-reactive depression), so that psychotherapy is instead the treatment of choice ... 

Neurobehavioral dysfunction is present, including diminished mental acuity and mood alterations (such as reactive depression, irritability, anxiety tension, confusion, fatigue and anger). 

Finally, patients must be in the proper mental frame of mind to be receptive to sexual stimuli. Patients who suffer from malaise, have reactive depression or performance anxiety, are sedated, have Alzheimer s disease, have hypothyroidism, or have mental disorders, commonly complain of erectile dysfunction. In most studies, patients with psychogenic erectile dysfunction generally exhibit a higher response rate to various interventions than do patients with organic erectile dysfunction, as their disease is often less severe. 

Mild Antidepressant, Antifatigue Agents, useful in the treatment of mild reactive depressions arising from emotional exhaustion and mental fatigue. Drugs such as pipradol (7, 28, 87) (Meratran), methylphenidate (Ritalin) (74, 80,112), Sch 5472 (77, 97), and W-1206 (51, 55) (Reactivan) are representative of this class. They produce their antidepressant effect principally through psychomotor stimulation. 

Many subsequent investigators confirmed Kuhn s original observations. Thus, Kiloh and Ball (57) showed that after 6 months the remission rate obtained with ECT equaled that of imipramine. Improvement began after 5 days to 6 weeks in endogenous depressions. Maximum improvement occurred after 2 to 12 weeks. In reactive depressions, onset was slower, with a mean of 18 days. Maximum improvement ranged from 10 days to 24 weeks. Side effects occurred as follows ... 

Amitriptyline resembled imipramine in its efficacy in the treatment of endogenous depression and its relative ineffectiveness in patients with neurotic (reactive) depressive symptoms (9). Some patients, who were unreactive to imipramine, responded to amitriptyline (9). Side effects were usually less severe (9, 34, 114) but there was a high incidence (18%) of somnolence (114). Some of the disadvantages inherent in imipramine were overcome, at least to some extent, by this structural variant ... 

Depression is often divided into two sub-types - reactive depression and endogenous depression. Reactive depression is usually associated with stressful life events, whereas endogenous depression is a persistent alteration of mood with no obvious cause. 

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