๐”– Bobbio Scriptorium
โœฆ   LIBER   โœฆ

Depression in the medically ill: Management considerations

โœ Scribed by Dwight L. Evans; Jeffrey Staab; Herb Ward; Jane Leserman; Diane O. Perkins; Robert N. Golden; John M. Petitto

Publisher
John Wiley and Sons
Year
1996
Tongue
English
Weight
129 KB
Volume
4
Category
Article
ISSN
1091-4269

No coin nor oath required. For personal study only.

โœฆ Synopsis

This article reviews the management of depression in three medical conditions associated with a high frequency of depression: coronary artery disease (CAD), cancer, and human immunodeficiency virus (HIV) infection. Major depression significantly increases mortality in patients with CAD. This effect of depression may be mediated by a decrease in heart rate variability. Tricyclic antidepressants (TCAs) possess Type 1A antiarrhythmic activity, which may increase the risk of sudden death. Initial data suggest that tricyclic antidepressants also may decrease heart rate variability. Antidepressant therapy is effective and can improve quality of life for patients with cancer or HIV infection. Strong social support or psychosocial interventions that improve coping skills may positively affect outcome in HIV infection and cancer. Selective serotonin reuptake inhibitors (SSRIs) and new agents may be well suited for use in depressed patients with medical illnesses because they lack the significant adverse anticholinergic and cardiovascular effects of TCAs and other classes of antidepressants.

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