Recognition and management of depression in primary care: a focus on the elderly. A pharmacotherapeutic overview of the selection process among the traditional and new antidepressants

American Journal of Therapeutics
R L BarkinS J Barkin

Abstract

Depressed patients consult with their primary care physician before engaging the services of a mental health care provider. Primary care physicians initiate more antidepressant pharmacotherapy than psychiatrists. Major depression has been estimated to have a 5% to 10% prevalence, with up to three times that percentage having significant subsyndromal depression symptoms. Patients frequently deny their depression, often neglecting to recognize their own somatic and cognitive/behavioral subjective symptoms, underestimating symptom severity, and possessing a reluctance to validate their existence because of social stigmata. There remains an underrecognition of the diagnosis of depression by primary care physicians. Often, depressed primary care patients present with somatic symptoms, which include gastrointestinal, skeletal muscle, and cardiovascular complaints, as opposed to describing nonsomatic criteria for depression. Elderly patients presenting with depression have an estimated prevalence of 5% to 50%, and the rate of suicide increases with age. In this patient group, depression may exist independently or secondary to insults or events. Major depressive disorders occur throughout the life cycle; however, the rate of major depr...Continue Reading

Citations

Mar 5, 2004·American Journal of Therapeutics·Robert L Barkin, Asokumar Buvanendran
May 23, 2008·American Journal of Therapeutics·Warren A Katz, Robert L Barkin
Mar 27, 2020·Journal of Clinical Medicine·Ali TeymooriNicole V Steinbüchel
Mar 21, 2002·Epilepsia·Gaetano Zaccara, Cesare Maria Cornaggia
Dec 14, 2006·Pain Practice : the Official Journal of World Institute of Pain·Kenneth C Jackson, Erin L St Onge
Oct 11, 2016·Expert Opinion on Drug Metabolism & Toxicology·Madia LozuponeDavide Seripa
Feb 23, 2019·Expert Opinion on Pharmacotherapy·Morohunfolu Akinnusi, Ali A El Solh
Jan 11, 2003·American Journal of Therapeutics·Joseph Prandota
Nov 24, 2006·American Journal of Therapeutics·Robert L BarkinDiana S Barkin
May 21, 2003·American Journal of Therapeutics·Bill McCarbergSteven M Schmidt
Sep 17, 2003·American Journal of Therapeutics·Ronald H BradleyCharles William Dodge
Jun 16, 2012·American Journal of Law & Medicine·Marshall B Kapp
Mar 31, 2010·Disease-a-month : DM·Warren A Katz, Robert L Barkin

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