Michael Quach, MD
Board Certified Psychiatrist
Integrative Psychiatry for Men

Depression

The lifetime prevalence of depression is about 17% overall, with the female to male ratio of about 1.7 to 1.  The average age of onset is 29 years.  Sadly, up to about 15% of depressed patients commit suicide.  Major depression is highly co-morbid with other disorders including anxiety disorder, substance use disorder, conduct disorder, ADHD, intermittent explosive disorder, and oppositional defiant disorder. 

Major depression is a recurrent illness.  The risk of relapse after one episode is 50%, and the risk of relapse after 3 episodes is more than 80%. 

There are many different anti-depressants being used to treat depression.  Usually, patients are prescribed Selective Serotonin Reuptake Inhibitors such as Prozac, Zoloft, Celexa, Paxil, and Lexapro as a first-line medication.  Other anti-depressants are also being used, such as Effexor, Cymbalta, Pristiq, Wellbutrin, Remeron, TCAs, and MAOIs.  Augmentation and combination strategies include agents such as Abilify, Seroquel, Lithium, T3, and Ritalin.  Other treatment modalities include ECT, VNS, TMS, bright light therapy, and psychotherapy. 

Effective psychotherapies for depression include: Cognitive Behavioral Therapy, Interpersonal Psychotherapy, Problem-Solving Therapy, and Psychodynamic Psychotherapy.


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