Treatment of Recurrent Depression

208 Pages·2001·2.51 MB·English

by  John F.

Treatment of
Recurrent Depression
Review of Psychiatry Series
John M. Oldham, M.D.
Michelle B. Riba, M.D., M.S.
Series Editors
Treatment of
Recurrent Depression
EDITED BY
John F. Greden, M.D.
No. 5
Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book
concerning drug dosages, schedules, and routes of administration is accurate as
of the time of publication and consistent with standards set by the U.S. Food and
Drug Administration and the general medical community. As medical research
and practice advance, however, therapeutic standards may change. For this
reason and because human and mechanical errors sometimes occur, we
recommend that readers follow the advice of a physician who is directly involved
in their care or the care of a member of their family. A product’s current package
insert should be consulted for full prescribing and safety information.
Books published by American Psychiatric Publishing, Inc., represent the views
and opinions of the individual authors and do not necessarily represent the
policies and opinions of APPI or the American Psychiatric Association.
Copyright © 2001 American Psychiatric Publishing, Inc.
04 03 02 01 4 3 2 1
ALL RIGHTS RESERVED
Manufactured in the United States of America on acid-free paper
First Edition
American Psychiatric Publishing, Inc.
1400 K Street, NW
Washington, DC 20005
www.appi.org
The correct citation for this book is
Greden JF (editor): Treatment of Recurrent Depression (Review of Psychiatry
Series, Volume 20, Number 5; Oldham JM and Riba MB, series editors).
Washington, DC, American Psychiatric Publishing, 2001
Library of Congress Cataloging-in-Publication Data
Treatment of recurrent depression / edited by John F. Greden.
p. ; cm. — (Review of psychiatry ; v. 20, n. 5)
Includes bibliographical references and index.
ISBN 1-58562-025-4 (alk. paper)
1. Depression, Mental. 2. Depression, Mental—Treatment. I. Greden, John
F., 1942– II. Review of psychiatry series v. 20, 5.
[DNLM: 1. Depressive Disorder—therapy. 2. Depressive Disorder—
prevention & control. 3. Recurrence—prevention and control. WM 171 T7844
2001]
RC537 .T742 2001
616.85′2706—dc21
00-069520
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Cover illustration: Copyright© 2001 Amy DeVoogd/Artville.
Dedicated to those caring, magnanimous
individuals who support the research
necessary to conquer depression

Contents
Contributors xi
Introduction to the Review of Psychiatry Series xv
John M. Oldham, M.D., and
Michelle B. Riba, M.D., M.S., Series Editors
Chapter 1
Recurrent Depression: Its Overwhelming Burden 1
John F. Greden, M.D.
Widespread Prevalence 3
Early Symptom Onset 4
Underdiagnosis and Undertreatment 5
Genetic Vulnerability 7
Frequent Recurrences 8
Inadequate Emphasis on RecurrencePrevention 10
Poor Maintenance Treatment
Adherence and Stigma 11
Brain Tissue Degeneration 12
Strategies to Prevent Recurrences and
Reduce the Burden of MDD 14
References 15
Chapter 2
Recurrent Depression in Women
Throughout the Life Span 19
Sheila M. Marcus, M.D.
Heather A. Flynn, Ph.D.
Elizabeth A. Young, M.D.
Neera Ghaziuddin, M.D.
Sharon Mudd, M.S., R.N., C.S., N.P.
Depression in Adolescence 19
Depression in Pregnancy and the
Postpartum Period 27
Depression in Midlife 40
The Need for More Research 48
Conclusion 50
References 50
Chapter 3
Chronic and RecurrentDepression:
Pharmacotherapy and Psychotherapy Combinations 59
Robert Boland, M.D.
Martin B. Keller, M.D.
Importance of Adequate Treatment 60
Medication Treatment 61
Combination Treatment 65
Current Issues, Unanswered Questions 74
Conclusion 77
References 78
Chapter 4
Prevention of Recurrences in Patients With Bipolar
Disorder: The Best of the Old and the New 81
Charles L. Bowden, M.D.
Cheryl L. Gonzales, M.D.
Goals of Care for Patients WithBipolarDisorder 81
Pharmacotherapy 89
Combination Treatment 97
Summary 98
References 98
Chapter 5
New Depression TreatmentStrategies:
What Does the Future Hold for Therapeutic
Uses of Minimally InvasiveBrain Stimulation? 103
Mark S. George, M.D.
Ziad Nahas, M.D.
Xing-Bao Li, M.D.
Jeong-Ho Chae, M.D.
Nicholas Oliver, B.S.
Arif Najib, B.S.
Berry Anderson, R.N.
Electroconvulsive Therapy 106
Transcranial Magnetic Stimulation 109
Vagus Nerve Stimulation 119
Deep Brain Stimulation 130
Conclusion 134
References 135
Chapter 6
Clinical Prevention of Recurrent
Depression: The Need for Paradigm Shifts 143
John F. Greden, M.D.
MDD Versus Other Diseases:
WhatCanWeLearn? 143
Clinical Strategies for Preventing
Recurrences of Major Depressive Disorder 146
Pressing Research Challenges 150
Treatment of Recurrent MDD:
The Need for Paradigm Shifts 153
Conclusion 164
References 165
Index 171