 Key features of depression and its management in general practice. |
| "..Everything
is ok in that department.." |
| In considering alternate treatments, which of the following statements are true of antidepressants treatment and electroconvulsive therapy (ECT) in this context? |
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1. Tricyclic antidepressants cause orthostatic hypotension. |
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2.
Tricyclic antidepressants are recommended for people with ischaemic
heart disease.
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3. The adverse effects of SSRIs usually settle within the first one or two weeks of treatment. |
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4.
If adverse effects are persistent, it is best to switch to another
class of antidepressants.
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5.
Patients with cardiac disease are at increased risk of cardiovascular
complications during ECT.
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Author's answer: False
Studies of type 1 antiarrhythmic therapy for patients with myocardial infarction and ventricular ectopy demonstrated that antiarrhythmic therapy was associated with increased mortality. Consequently, tricyclic agents are no longer recommended as first-line drugs in treatment of depression in patients with ischemic heart disease.