WEB EXTRA!
Prescribing tips for antidepressants
- Related content
- Mood disorders monograph offers advice on
antidepressant use
The FDA's advisory on antidepressant use should not deter the family
physician who has the appropriate knowledge and will take the time to prescribe
correctly, says Robert Gillette, M.D., medical editor for AAFP's monograph
Diagnosis and Management of Mood Disorders. Here are his tips on
prescribing:
- Take a focused history, including time course (new onset vs.
episodic vs. chronic), impact of the illness on the patient's life, relation of
symptoms to significant losses or other life events, and episodes of elated
mood or other symptoms that suggest bipolar disorder.
- Inquire about suicidal thinking and obtain agreement that the
patient will contact you if this becomes problematic.
- Build a relationship of trust and open communication with the
patient.
- Provide relative information to the patient (and perhaps also
significant others), including the need to manage the illness continuously over
time.
- Provide regular follow-up -- at least weekly at first -- to assess
for symptom relief or exacerbation, side effects, suicidal thinking, and
adherence to the prescribed program.
- Consult a psychiatrist if any of the following appear:
- an increase in suicidal thinking, especially if the patient has
a concrete plan in mind;
- failure to improve or worsening of symptoms while the patient
is on medication;
- major side effects; or
- symptoms or behavior suggestive of bipolar disorder.
FP Report is published by the
AAFP News Department.
Copyright © 2004 by
American Academy of Family Physicians.
