Top Treatments for Major depressive disorder | Clinical Practice guidelines

In this video, we discuss medications used as treatment for Major Depressive Disorder and what the recent treatment guidelines suggest as first-line treatments which include second-generation antidepressants such as SSRIs, SNRIs, NDRI’s, and Multi-modal antidepressants. Top medications from each of these classes are discussed including potential side effects.

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Intro 0:00
Considerations 00:33
SSRIs 01:26
SNRIs 05:29
Atypical antidepressants:
Bupropion 08:29
Vortioxetine 09:45
Mirtazapine 10:55
Rare and Dangerous side effects 12:41
Takeaways 16:52

Resources:
Deprescribing Guide: https://amzn.to/4dZEUMk
Stahl’s Prescribing Guide: https://amzn.to/3UXj8QL

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice, or substituted for diagnosis and treatment of any conditions discussed herein. Furthermore, watching these videos or getting answers to comments/questions, does not establish a provider-patient relationship. Please consult with your own health care provider for proper diagnosis and treatment.

References:
American Psychological Association (APA). (2019). Clinical practice guideline for the treatment of depression across three age cohorts. APA.org. Retrieved from https://www.apa.org/depression-guideline
Bjarnadottir, A. (2018, December 4). A guide to common antidepressant side effects. Healthline. Retrieved from https://www.healthline.com/health/antidepressant-side-effects
Hirsch, M., & Birnbaum, R. J. (2019) Sexual dysfunction caused by selective serotonin reuptake inhibitors (SSRIs): Management. Up To Date. Retrieved from https://www-uptodate-com.libproxy.eku.edu/contents/sexual-dysfunction-caused-by-selective-serotonin-reuptake-inhibitors-ssris-management?search=Sexual%20dysfunction%20caused%20by%20selective%20serotonin%20reuptake%20inhibitors%20(SSRIs):%20Management&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., McInerney, S. J., McIntosh, D., Milev, R. V., Müller, D. J., Parikh, S. V., Pearson, N. L., Ravindran, A. V., Uher, R., & CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical guidelines for the management of adults with major depressive disorder: Section 3. Pharmacological treatments. Canadian Journal of Psychiatry, 61(9), 540–560. https://doi-org.libproxy.eku.edu/10.1177/0706743716659417
Rush, J.A (2020). Unipolar major depression in adults: Choosing initial treatment. Up to Date. Retrieved from https://www-uptodate-com.libproxy.eku.edu/contents/unipolar-major-depression-in-adults-choosing-initial-treatment?search=antidepressants&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
Stahl, S. (2017). Stahl’s essential psychopharmacology: prescribers guide (6th ed.). New York,
N.Y.: Cambridge University Press.

This video was created using the following:
Doodly v2.6.3
Pixabay.com
Adobe Premiere- editing software

32 Comments

  1. The audio in this video is a lot better than the other ones I've seen. Now all you need is something for the reverb and the quality will be superb. Thanks for the high quality straight to the point content!

  2. Why are you not indicating the most dangerous side effects: akhatisia, mania, psychosis that can cause suicide, violence… ? This is well stated in the notice for FDA approval though. Lie by omission.

  3. It is imposible not to quit an antidepressant when you don’t tolerate it and your doctor is reluctant to talk before your appointment

  4. Thank you for a wonderful video!! My Dr suggested Mirtazapine 7.5 mg for sleep, just worried abt side effects. Also was suggested to start Buspar 30mg. Question can Buspar help with sleep anxiety?
    God Bless you

  5. Great videos, I want to go on an anxiety medication and the reason why is because I had a bad experience by trying marijuanna just once and from that point I started to get excessive worry and anxiety and depression and became ver traumatized by this event and since then I worry excessively about the negative experience with the weed, now I have 2 questions the 1st question is did I permanently mess up by brain chemistry and the next question is should I go back on an anxiety medication for example paroxetine since it have help me in the past to think less of the the negative weed event.

  6. Great video again!
    Would love to see a video on bipolar meds and explaining what each one differs and why sometimes people have to take more than 1 med.

  7. Could you do a video on antidepressant augmentation approaches (eg bupropion, aripiprazole, brexpiprazole, etc) and how they compare to each other and to monotherapy?

  8. I am taking 5 mg of Buspar twice a day and 37.5 mg of Effexor…just started 4 days ago…very agitated…I am 79 years old and had a stroke one year ago…i am very agitated and wired…is this common?

  9. I am taking paroxytene 37.5 + D Venlor 100 for the past 6 years.
    For the past one year, I am having a lot of negative thoughts and feel lethargic the whole day. I sleep a lot.
    Is it that I have developed a resistance to these drugs and need to change them?
    Please help.

  10. Experience: mirtazapine make me feel like I was tripping on psychedelics, I did some Google/Bing to see if others had the same experience, turns out others have had this reaction, never had this with other antidepressants, and I've tried them many

  11. I was on Prozac for 20 years and did very well. My dad passed awsy in February and I wasn’t going well so we increased the dose but I got worse after 2 dose increases. Did genesight and it is in my red. I’ve failed 2 meds in my green. Would you recommend I go back to Prozac?

  12. Hi these videos are so useful to start with but my question is I’ve been prescribed Zoloft for intrusive thoughts that’s led to major panic and anxiety leading to depression! I’m on week 4 ( 2 weeks on 50mg) (2weeks on 100mg) my side effect that has not gone is stomach upsets (diarrhoea) and increased anxiety especially to start! It this normal? And does that mean the drug is actually working and the side effects should subside and eventually I’ll get the better in the coming weeks?

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