The Psychopharmacological Treatment of Depression in the Medically III Patient^*

Abstract

With the introduction of effective antidepressants, pharmacotherapy has not been limited exclusively to the psychiatrically ill, but has been expanded to include medically ill patients exhibiting depressive symptomatology as well. This has led to problems in diagnostic differentiation and, just as important, problems with interactions resulting from multiple medications. By describing the coexistence of depressive symptomatology in a large variety of physical illness, the physician is alerted to the complexities of psychiatric illness in the medically ill patient as well as the caution necessitated by the poly-pharmacotherapy required in this population.

Network analysis of the relationship between depressive symptoms, demographics, nutrition, quality of life and medical condition factors in the Osteoarthritis Initiative database cohort of elderly North-American adults with or at risk for osteoarthritis

“…The same is true for the metabolic syndrome (RR = 1.58; 95% CI 1.35–1.86) (Vancampfort et al ., 2015), as well as ultimately cardiovascular disease prevalence (O1.53, 95% CI 1.27–1.83) and incidence (H1.78, 95% CI 1.60–1.98) (Correll et al ., 2017). Such high comorbidity figures often complicate medication prescriptions, ultimately resulting in polypharmacotherapy, with related drug–drug interactions and safety or tolerability issues (Ban et al ., 1984; Frye et al ., 2000).…”

Management of Depression in Medical Patients

“…Several reviews on the use of psychotropic drugs in medical patients are available [8,66,112,153,155]. The clini cally relevant interactions of antidepressant drugs and disease states (table IV) or drugs primarily directed to physical disturbances (table V), will be emphasized.…”