Key features of depression and its
management in general practice.
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"..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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5.
Patients with cardiac disease are at increased risk of cardiovascular complications
during ECT.
Author's
answer: True
Available
information suggests that patients with cardiac disease are more likely
to experience cardiovascular complications during ECT than patients without
heart disease. During ECT, heart rate and blood pressure increase substantially,
followed by a vagally mediated bradycardia. Patients with ischemic heart
disease or ventricular arrhythmias are at increased risk of myocardial
infarction or ventricular tachyarrhythmias. Most complications are transient,
however, and do not necessarily preclude use of this modality.
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