Contraindications to Use of Antidepressant and Antimanic M

Antidepressant and Antimanic Medications: Contraindications to Use of Antidepressant and Antimanic Medications

There are few contraindications to antidepressant or antimanic medication treatment. Those that do exist are mostly related to specific drugs or to combinations of drugs and are discussed individually in the following sections of this chapter dealing with specific drug types and side effects.

General Treatment Guidelines
The treatment of mood disorders is increasingly recognized as a long-term process, because mood disorders appear to be chronic in nature and patients with mood disorders experience high rates of relapse on discontinuation of drug therapy. Available medications restore function, but the disease process is not halted. In this context, Kupfer (1991) proposed three phases of treatment: an acute-treatment phase, a continuation phase, and a maintenance phase. These concepts are also appropriate to the treatment of mania. The phases are defined in relation to the status of symptoms and involve the concepts of treatment response, relapse, remission, recurrence, and recovery. The phases of treatment for depression are depicted in Figure 39-1.

Response refers to some effect following an action—in this case a decrease in clinically significant symptoms after initiation of treatment. Relapse involves the return of some symptoms during or on cessation of treatment. Remission refers to a clinically meaningful decrease in symptoms. Recurrence describes the return of symptoms after a remission. Recovery describes a more sustained remission from the most recent episode.

Antidepressant and Antimanic Medications Introduction Diagnostic Indications and Contraindications

• Indications for Use of Antidepressant and Antimanic Medications
• Contraindications to Use of Antidepressant and Antimanic Medications
• General Treatment Guidelines Antidepressant Medications: Pharmacological Properties and Evidence for Acute-Phase Efficacy