Up To Date January

* tratamentul depresiei rezistente

Let's talk about FDA approvals. Quetiapine and quetiapine XR are FDA approved for treating bipolar depression as monotherapy. We have more options with adjunctive treatments. Aripiprazole was approved as an augmentation strategy for resistant major depression.





* tratamentul antidepresiv

Depressive disorders are common. Bipolar depression is often under-recognized and misdiagnosed as unipolar. Approximately one third to one half of patients with unipolar depression do not respond fully to antidepressant therapy.





* antidepresivele

  1. A patient presenting with symptoms consistent with major depressive disorder reports loss of pleasure or interest in activities that she previously enjoyed. Which region of the brain is most strongly implicated with such reactions?
    Answer: Anterior cingulate cortex
    Symptoms of depression -- and the neurologic pathways associated with their treatment -- involve multiple regions of the brain related to memory, emotion, anticipation and decision making. The anterior cingulated cortex is most closely associated with hedonistic behavior or pleasure, while the amygdala, hippocampus, and prefrontal cortex are associated with affect, memory, and decision making, respectively.
  2. Based on current understanding of depression's effect on the brain and the effects of antidepressants in animal models of depression, an effective pharmacologic treatment is thought to do all but which of the following?
    Answer: Stimulating amygdala activity to emotional associations
    The causes of depression are multifactorial; genetics may predispose some individuals to depression above and beyond the risk from general life stressors via heightened sensitivity to emotional responses. Imaging and other studies suggest that both that stress and depression have deteriorating effects on various regions of the brain, and that antidepressants can mitigate or help to reverse these effects, which range from atrophy to decreased metabolic activity in various brain regions. Restoring neurogenesis is thought to be one way by which antidepressants can increase hippocampal volume.

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