Depression and resistant depression

Depression is one of the most common mental disorders that can cause significant suffering and loss of productivity. It is characterized by negative thinking, low mood, low energy to work and inability to feel pleasure.

There are several treatment modalities available for depression and it depends on the severity and other associated features of it. Antidepressants are the most common method of treatment. However, around 50% of patients do not achieve satisfactory symptom control with single anti-depressant. It is a very significant failure rate.

Treatment resistant depression (around 40 – 30% of all depressed patients) is usually treated with augmentation (Lithium, Buspiron, Anti psychotics). Some patients need to try different anti-depressant until a responding medication is found.  Other people need Electro convulsive therapy for symptom relief but the effect is short lasting. 

The main reason for above failure rate is the lack of understanding about the mechanism of depression. First Anti-depressant is in fact discovered by an accident. All New anti-depressants are modifications of the original anti-depressant (Imipramine).  None of the newer anti-depressants are superior to Imipramine in terms of Efficacy (“Effectiveness”).

Some clinicians practice regular maintenance ECT for resistant depression (usually once a week). Recent review on published trials regarding maintenance ECT concludes that patients need to be given the choice.  

Sometimes cognitive behavior therapy and supportive psychotherapy help patients to cope with depression.

Another promising finding is the effectiveness of Ketamine (Anesthetic medication) in treating depression. 

Unlike other antidepressants Ketamine relieves depression within hours and mechanism of Ketamine is completely different to conventional anti-depressants. But the effect is short lasting. However, it opens a whole new path for scientists to uncover regarding the mechanism of depression.

Finally it seems there is currently no magic bullet for treatment of depression. But future is not gloomy, because scientists are trying to find out the exact cause for depression and hopefully find a better treatment options. 

Symptoms and treatment of Major Depression

Prodep uses and side effects

Prodep is an indian brand name of the SSRI Fluoxetine. It is used in depression, OCD, and other anxiety disorders.  Main side effects are nausea, gastric discomfort and sexual dysfunction.


What are the uses?

This medication mainly used to treat clinical Depression that is characterized by persistent low mood, lack of enjoyment in life, suicidal thoughts and lack of energy. Other than that Prodep is prescribed for obsessive compulsive disorders and anxiety disorders.  But the patients must take this medication for more than two weeks to see an effect.

Prodep is primarily used for clinical depression. Depression is characterized by persistent low mood, lack of energy to do day to day activities and unable to feel pleasure. If the symptoms are persisting for more than two weeks then you need to meet your family doctor. 

In addition, it is widely used for obsessive compulsive disorder and panic disorder. It is also used as a treatment for premature ejaculation.

In addition, to causing suffering depression is known to cause heart problems.

Please click following link to learn more about depression and heart problems such as heart attacks.

This medication is prescribed for depressive disorder, anxiety disorder such as panic disorder and social phobia. According to Multiple treatment Meta – analysis done by A. Cipriani, , 
Venlift OD (Venlafaxine) is more effective than Fluoxetine. Serdep is another medication is SSRI class that is prescribed for depression and anxiety disorders. 

Relationship between depression and heart problems

Prodep 20mg capsules

How Prodep® works?

Prodep act by inhibiting serotonin reuptake pumps in neuronal synapses in certain brain areas. This action increases the levels of serotonin in certain nerve endings. Then increased serotonin initiates cascade of reactions treats depression and other problems this drug prescribed. Side effects are mainly caused by increased serotonin levels in unfavorable brain areas.

But the side effects such as tremors and insomnia occurs early and they usually wane after two to three months of therapy.

What the doctor should know before prescribing Prodep?

If the patient has

• liver problems
• kidney problems
• bipolar mania

then he/she must discuss with the doctor. In addition this drug can have dangerous interactions with certain drugs such as Theophylline and Aminophylline. But they are common ingredients of over the counter cough syrups. So patient must inform their complete drug history to the prescribing doctor.  In addition, patients should not take alcohol containing beverages with Prodep, since it can cause serious problems.

What are the less dangerous but common side effects?

Nausea, vomiting, dyspepsia, abdominal pain and skin rashes are main side effects. Certain patient can report short term anxiety and agitation. Insomnia is also another troublesome side effect. But it can be controlled by taking the medication in the morning. Sexual dysfunction such as impotence and lack of desire can occur with both male female patients.

What are the dangerous side effects?

Some patients can rarely get allergic to Prodep. They can have a condition called anaphylactic reaction characterized by wide spread hives, shortness of breath and chest tightness. If present, emergency medical treatment must be sought.

Certain patients can develop a condition called neuroleptic malignant syndrome with Prodep. It is characterized by sudden onset muscle rigidity, fever and loss of consciousness.

Even though this is an anti-depressant, this medication is known to increase suicidal risk in susceptible individuals, especially teenagers.

Why suicide in an anti-depressant?

Usually depressed people tend to have lack of energy. It prevents them from harming themselves. Prodep increases energy level in the patient before relieving depression. This may be the main cause for increased suicidal risk.

Summary

Prodep is an anti-depressant in the SSRI family. Most common and troublesome side effects are sexual dysfunction, tremors, insomnia and gastrointestinal discomfort (nausea, vomiting and abdominal pain). Other than that this drug is a safe and well tested drug.

Medications prescribed for Alcohol and opioid addiction

Uses and side effects of Nodict tablets

Sources

British National formulary