ABSTRACT
El uso de litio es tan antiguo como su historia generándose en el tiempo voces detractoras e como importantes defensores. En Ecuador, no está exenta esta controversia soslayándose el uso de litio para tratar cuadros el trastorno bipolar, eventos suicidas y como coadyuvante en casos de depresión resistente al tratamiento, pese a ser un medicamento básico de comprobada eficacia en estas patologías. Un manejo y monitoreo adecuados, evitaría su sustitución por medicamentos de mayor costo sobre todo para el Sistema Nacional de Salud Pública, que asiste a un importante segmento poblacional de bajos recursos económicos.(AU)
The use of lithium is as old as its history, generating in time detractor voices and as important defenders. In Ecuador, this controversy is not exempt from the use of lithium to treat bipolar disorder, suicidal events and as an adjuvant in cases of treatment-resistant depression, despite being a basic drug with proven efficacy in these pathologies. Adequate management and monitoring would avoid its substitution by drugs of greater cost, especially for the National Public Health System, which assists an important segment of the population with low economic resources. (AU)
Subject(s)
Humans , Animals , Male , Female , Adult , Mental Health , Lithium Carbonate , Behavioral Disciplines and Activities , Psychological Phenomena , Lithium , Mental Health ServicesABSTRACT
Less than one third of patients who suffer from major depressive disorder (MDD) report remission following antidepressant treatments requiring more diverse treatment approaches. Augmentation of second generation antipsychotics (SGAs) has been increasingly recognized as an important treatment option. The authors have previously provided a comprehensive review of SGAs for the treatment of MDD in 2013. Since then, numerous additional clinical trials have been conducted to investigate diverse issues regarding the utility of SGAs in MDD. Moreover, a new SGA, brexpiprazole, was recently approved by the Food and Drug Administration in July 2015 for the treatment of MDD as an augmentation agent to antidepressants. Thus, the aim of this study was to provide a concise update of all the available SGAs for the treatment of MDD, in particular on the additional clinical trials which have been published since 2013.
Subject(s)
Humans , Antidepressive Agents , Antipsychotic Agents , Depressive Disorder , Depressive Disorder, Major , Depressive Disorder, Treatment-Resistant , United States Food and Drug AdministrationABSTRACT
Less than one third of patients who suffer from major depressive disorder (MDD) report remission following antidepressant treatments requiring more diverse treatment approaches. Augmentation of second generation antipsychotics (SGAs) has been increasingly recognized as an important treatment option. The authors have previously provided a comprehensive review of SGAs for the treatment of MDD in 2013. Since then, numerous additional clinical trials have been conducted to investigate diverse issues regarding the utility of SGAs in MDD. Moreover, a new SGA, brexpiprazole, was recently approved by the Food and Drug Administration in July 2015 for the treatment of MDD as an augmentation agent to antidepressants. Thus, the aim of this study was to provide a concise update of all the available SGAs for the treatment of MDD, in particular on the additional clinical trials which have been published since 2013.
Subject(s)
Humans , Antidepressive Agents , Antipsychotic Agents , Depressive Disorder , Depressive Disorder, Major , Depressive Disorder, Treatment-Resistant , United States Food and Drug AdministrationABSTRACT
Introducción: El objetivo del presente artículo es presentar las recomendaciones basadas en la evidencia que surgieron como respuesta a una serie de preguntas clínicas con respecto al episodio depresivo y al trastorno depresivo recurrente, haciendo hincapié en los aspectos generales del tratamiento de la depresión resistente y la depresión con psicosis, el tratamiento con terapia ocupacional y el hospital día, con el fin de brindar parámetros de atención en salud basados en la mejor y más actualizada evidencia disponible para lograr los estándares mínimos de calidad en el abordaje de adultos con dichos diagnósticos. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de la Protección Social. Se adaptaron las recomendaciones de las guías NICE90 y CANMAT para las preguntas que estas guías contestaban y se desarrollaron de novo para las preguntas no encontradas. Resultados: Se presentan las recomendaciones 23-25 correspondientes al manejo de la depresión...
Introduction: This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. Methodology:A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while denovo questions were developed. Results: Recommendations 23-25 corresponding to the management of depression are presented...