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Refractory Depression (Advances in Neuropsychiatry and Psychopharmacology)
Refractory Depression - Advances in Neuropsychiatry and Psychopharmacology Author:Jay D. Amsterdam (Editor) This focuses on endogenous depression that does not respond well to conventional pharmacological therapy or electroconvulsive therapy. More than 40 investigators present their findings and views on the nosology, classification, etiology and diagnosis of therapy-resistant depression and provide information on treatment strategies. The opening cha... more »pter offers insights on the clinical description and nosology of treatment-resistant depressions, based on a systematic evaluation of 300 patients. Attention is given to the clinical features and etiology of specific syndromes such as treatment-resistant manic-depressive disorder and rapid cycling bipolar disorder. Clinicians explore the role of polysomnography in evaluation of refractory depression and emphasize the importance of a trial of electroconvulsive therapy before a diagnosis of refractory depression is made. A review of principles of rational drug selection prepares the reader for the discussions of individual drugs and drug combinations. A major portion of the book describes pharmacological therapies including fluoxetine enhancement of tricyclic antidepressants, combined treatment with imipramine and mianserine, combination therapy with monoamine oxidase inhibitors and tricyclic antidepressants, high-dose tranylcypromine, thyroid hormone potentiation of antidepressants, reserpine treatment, and narcotherapy. The contributors present definitive recommendations on use of anticonvulsants for lithium-refractory bipolar depressed patients and use of psychostimulants and lithium augmentation for refractory depression in elderly patients. The role of stereotactic cingulotomy in the treatment of intractable depression is also assessed.« less