Morning Report

Paradigm Shift in Depression: Can an Antidepressant Make Things Worse?

Arefa Cassoobhoy, MD, MPH

Disclosures

June 02, 2017

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

Mixed Depression Guidelines a Paradigm Shift

One third or more of adults diagnosed with major depression also have symptoms of hypomania or mania. In a paradigm shift, new guidelines suggest that patients with mixed features may gain more benefit from an antipsychotic than from an antidepressant.

In patients suffering from depression with mixed features, antidepressants alone typically don't work. They can actually worsen symptoms and even induce mania or suicidal thoughts. A referral to a psychiatrist may be needed to assist with diagnosis and treatment.

Clinicians are encouraged to think about the possibility of mixed features in all patients with depression. Monitor for signs of psychomotor acceleration. And remember, you won't know unless you ask about symptoms of mania or a family history of bipolar disorder.

For Medscape and WebMD, I'm Dr Arefa Cassoobhoy.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....