Therapy of Hospitalized Patients with Depression – are Antidepressives sufficient?
Authors:
E. Češková
Authors‘ workplace:
Psychiatrická klinika LF MU a FN, Brno
přednostka prof. MUDr. E. Češková, CSc.
Published in:
Čes. a slov. Psychiat., 105, 2009, No. 5, pp. 196-201.
Category:
Original Article
Overview
Most of the patients hospitalized with depression are suffering from severe and pharmacoresistant depressive disorder. The aim of the study was to assess the diagnostic spectrum and treatment modalities of in-patients suffering from recurrent depressive disorder.
Charts of patients consecutively hospitalized with this diagnosis between January 2005 and December 2006 were reviewed. During the 2-year period totally 115 patients (87 females 28 males) were hospitalized 150 times. 79.2% of hospitalizations were for moderate and severe depression, 11.3 % for psychotic depression. A monotherapy with antidepressants (AD) was used in 52/150 (34.6%) of hospitalizations, a monotherapy with antipsychotics in 17/150 (11.3 %) of hospitalizations. The most frequently used ADs were mirtazapine and escitalopram, the most frequently used antipsychotic olanzapine and quetiapine. A combination of two ADs was found in 18/150 (12%) of hospitalizations. The most frequently used combination was the combination of mirtazapine with SSRIs or venlafaxine. The most frequently used treatment strategy was augmentation with atypical APs - in 54/150 (36%) of hospitalizations. The most frequently augmented ADs were SSRIs and ADs were most frequently augmented with olanzapine and sulpiride or amisulpride. In addition to mentioned treatment strategies an augmentation with mood stabilizers in 36/150 (24%) and with electroconvulsive therapy 27/150 (18%) of hospitalizations was used. The mean daily doses of olanzapine and quetiapine were significantly lower in combinations with ADs compared to the monotherapy.
Key words:
recurrent depressive disorder, monotherapy, antidepressants, atypical antipsychotics, augmentation, combination.
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Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
2009 Issue 5
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