 Key features of depression and its management in general practice. |
| "..Everything
is ok in that department.." |
| Which
of the following statements are true in relation of his ongoing management? |
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1.
Sertraline is safe and effective for depression following myocardial
infarction.
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2.
Ali has a 50% chance of responding to another class of antidepressant.
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3.
Ali has a > 50% chance of responding to ECT.
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4.
Ali is unlikely to respond to augmentation of antidepressant treatment
with lithium.
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5.
When switching Ali between SSRIs and other antidepressants, it is
important to allow adequate time for drug clearance.
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5. When switching Ali between SSRIs and other antidepressants, it is important to allow adequate time for drug clearance.
Author's answer: True
A major safety issue is allowing adequate time for drug clearance when switching between SSRIs and other antidepressants, as SSRIs inhibit negative cytochrome P450 enzymes responsible for the metabolism of many of the antidepressants (6). It is important to avoid the serotonergic syndrome by allowing adequate time for drug clearance when switching between the irreversible MAOIs and other antidepressants.