Dr. Roger McIntyre, Professor of Psychiatry at the University of Toronto, discusses the differentiation of normal 'low mood' from psychiatric conditions. The podcast covers historical subtypes of depression, DSM specifiers for major depressive disorder, epidemiology, neurophysiology, and treatment options.
Psychotherapies like CBT, IPT, mindfulness therapy, and behavioral activation therapies are effective in treating depressive symptoms and can be delivered in various formats including virtual guided therapy.
When choosing medication for depression, it is important to consider individual patient factors such as anxiety, pain, cognitive problems, comorbid conditions, and side effect profiles to guide the choice of medication and minimize side effects.
Deep dives
Psychotherapy as a Treatment for Depression
Psychotherapies such as cognitive behavioral therapy (CBT), interpersonal therapy (IPT), mindfulness therapy, and behavioral activation therapies have been proven effective in mitigating depressive symptoms. These therapies can be delivered in individual or group formats, and virtualized guided psychotherapies have also gained acceptance.
Medication Options for Depression
For patients with a first major depressive episode, several classes of medications can be considered. This includes SSRIs, SNRIs, multimodal agents like bupropion, G5-HT1A agonists like vilazodone, NMDA and Sigma-1 agonists like dextromethorphan, and others. The choice of medication may be influenced by factors such as anxiety, pain, cognitive problems, comorbid conditions, and side effect profiles.
Considerations for Medication Selection
When selecting medications for depression, it's important to consider individual patient factors and symptom profiles. A patient's anxiety level, pain levels, cognitive impairments, or the presence of comorbidities can help guide medication choices. Additionally, avoiding side effects such as weight gain, sexual dysfunction, or sedation is an important consideration in selecting the right medication for each patient.
Prevention and Closing the Treatment Gap
There is a need to focus on prevention and closing the treatment gap in depression. Many effective treatments are available, and identifying high-risk individuals after their first episode of depression can prevent treatment-resistant depression. By implementing preventive measures and bridging the gap between knowledge and practice, the outcome for individuals with depression can be improved.
Dr. Roger McIntyre, Professor of Psychiatry and Pharmacology at the University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto, Canada, returns to introduce depressive disorders.
We differentiate normal "low mood" from conditions that warrant a psychiatric diagnosis. We discuss historical subtypes of depression and the current DSM specifiers for major depressive disorder. We review epidemiology, discuss the neurophysiology of depressive disorders, and then dive into treatment options.
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