Index
Note: Page numbers in italics indicate figures;
page numbers followed by t indicate tables.

Acetaminophen, 91t
Activity level, 13
   in different types of affective disorders, 16t
Acute therapeutic index, 105, 106t-114t, 115
Adolescents with depression
   antidepressant dosage for, 130t-131t
   irritability in, 14t
   suicide in, 21
Affect of patient
   in diagnosis of depression, 34t
   in different types of disorders, 16t
Age
   at depression onset
   atypical, 15
   melancholic, 15, 24
   suicide risk and, 40, 40t
Alcohol intake
   antidepressant drug therapy and, 84
   biochemical effects of, 23, 46
   as cause of depression, 17, 33
   gender differences in, 25-26
   self-medication with, 21
   suicide risk and, 40t
   TATCA with, 116
Alfentanil, 91t
Alpha-1–adrenergic receptor blockers
   dizziness from, 195-196
   sexual dysfunction and, 119
   TATCA effect on, 116
   tolerability of, 107t
Alprazolam, 92t
Alprenolol, 91t
Amiodarone, 91t
Amitriptyline (Elavil)
   action mechanisms of, 58t-59t, 62t-64t, 80
   action sites of, 80, 81
   cost of, 126t
Amitriptyline (continued)
   CYP enzymes and, 90t-91t
   dosage of, 130t, 132t-133t
   drug interaction with, 184-186
   effectiveness of, 83
   frequency of prescriptions for, 138t
   pharmacology of, 82-83
   STEPS criteria for, 107t
Amoxapine (Ascendin)
   action mechanisms of, 58t-59t
   dosage of, 130t, 132t-133t
   STEPS criteria for, 107t
Anafranil. See Clomipramine.
Analgesics, 91t
Androstenedione, 92t
Anorexia, 194
Antiarrhythmics
   CYP enzymes and, 91t
   TATCA effect on, 116
Anticonvulsants, 91t
Antidepressant drug therapy. See also specific drug or
drug type.
   action mechanisms of, 58t-59t, 62t-64t
   action sites of, 66t-67t
   addiction potential of, 51
   adverse effects of, 68t-76t, 78t-79t
   alternative monodrug therapy in, 205-206
   antipsychotics with, 208
   anxiolytics with, 207-208
   assessing progress in, 174, 175
   augmentation strategies in, 202-205
   clinical trials in, 52
   cost of, 51, 124-125, 126t-129t
   CYP enzymes and. See Cytochrome P450 enzymes,
   drug interactions with.
   dosage of, 130t-133t
   adjustments in, 201
   drug combinations in, 121-122, 206-207
   drug interactions in, 62t-64t, 66t-67t, 84, 116-117, 169-170, 179-191
   drug selection in, 137, 138t, 139
   duration of, 53-54, 177-178
Antidepressant drug therapy (continued)
   effectiveness of, 17, 119-120
   acute, 120-121
   drug combinations in, 121-122
   lag time before, 44-46
   maintenance, 123
   potency in, 81, 85
   prophylactic, 123-124
   response rate in, 121-122
   spectrum of, 122
   electroconvulsive therapy with, 209
   failure of, 205-207
   follow-up visits in, 172-174
   four “D’s” of, 40-51, 54
   goals in, 57
   half-lives in, 89, 95, 99-100
   Hamilton Depression Rating Scale in, 33t
   indications for, 49-50
   initiation of, 171
   lithium with, 18, 36, 208-209
   long-term health consequences of, 51
   maintenance therapy in, 178
   mood stabilizers with, 208-209
   noncompliance with, 54-55, 55t
   other medications with, 179, 180t, 181-184, 182t
   partial response in, 200-205
   pharmacodynamics of, 65-84
   pharmacokinetics of, 89, 117-118
   placebo response vs, 53t, 53-54
   rational drug development in, 59-60
   relationship among pharmacodynamics, pharmacokinet-
   ics, and interindividual variability in, 61, 65
   response vs remission with, 52, 53t
   safety in
   acute therapeutic index in, 105-106, 106t-114t, 115
   long term, 115-116
   simplicity of, 125-135
   STEPS criteria of, 50
   therapeutic trial of, 26
   tolerability in, 118-119
Antidepressant drug therapy (continued)
treatment of adverse effects in. See also specific drugs or
drug types.
   anorexia, 194-195
   confusion, 195
   constipation, 195
   diaphoresis, 195
   diarrhea, 195
   dizziness, 195-196
   drowsiness, 196-197
   drug or dose adjustment in, 194
   dry mouth, 197
   fatigue, 197-198
   hyperphagia, 198
   insomnia, 198
   nausea, 198-199
   nervousness, 199
   sexual dysfunction, 199
   vision disturbance, 199
   in treatment-refractory patients, 26
   withdrawal from, 100t-101t, 100-103
   Zung Depression Self-Report Rating Scale in, 176-177, 177
Antiestrogens, 92t
Antihistamines, 92t
Antihypertensive drugs, 17
   TATCA effect on, 116
Antipsychotic drugs
   antidepressants with, 208
   CYP enzymes and, 90t-92t
Anxiety disorders, serotonin selective reuptake inhibitors
   for, 135
Anxiolytics, antidepressants with, 207-208
Apathy, 13, 14t, 27
   in different types of affective disorders, 16t
Aphrodyne (yohimbine), 83t, 199
Appetite changes, 13
   in different types of affective disorders, 16t
Ascendin. See Amoxapine.
Astemizole, 92t
Attention. See Concentration/attention.
Atypical major depression
   family history in, 15
   onset age in, 15
   signs and symptoms of, 16t
Aventyl. See Nortriptyline.

Barbiturates, 90t
Benzodiazepines, 90t, 92t
Benzphetamine, 92t
Benztropine, 83t
Bereavement, 15t
Beta-blockers, 90t-91t
Biochemistry of brain
   alcohol intake and, 23, 46
   in depression, 44
Bipolar disorder
   family history of, 18
   signs and symptoms of, 16t, 17-18
Briquet’s syndrome, 36
Bufuralol, 91t
Bupropion (Wellbutrin, Zyban)
   action mechanism of, 58t-59t, 62t-63t
   action site of, 80
   advantages of, 164-165
   adverse effects of, 72t-75t, 78t, 198
   cost of, 129t
   CYP enzymes and, 166
   disadvantages of, 164-165
   dosage of, 131t-132t
   ascending, 135
   drug interactions with, 166-167, 199
   frequency of prescriptions for, 138t
   half-life of, 95
   indications for, 165, 167-168
   potency of, 86
   seizure risk with, 115, 165, 167
   sexual dysfunction and, 119
   STEPS criteria for, 113t, 164-165
   to stop smoking, 165
Buspirone (Buspar)
   as augmentation strategy, 204-205
   for sexual dysfunction, 199
Caffeine, 90t
Calcium channel blockers, 92t
Cancer, 17, 182t, 204
Carbamazepine
   antidepressant drugs with, 188-189
   CYP enzymes and, 91t
Causes of depression, 17, 33
Celexa. See Citalopram.
Children with depression
   antidepressant dosage for, 130t-131t
   irritability in, 14t
   weight changes in, 14t
Chlorpheniramine, 83t
Cholinergic rebound, 100, 100t
Cigarette smoking
   bupropion for cessation of, 165
   in depressed individuals, 23
Cimetidine, 83t
Cisapride, 92t
Citalopram (Celexa)
   action mechanism of, 58t-59t
   advantages of, 152
   adverse effects of, 68t-71t, 76t
   cost of, 127t
   CYP enzymes and, 90t, 94t, 96t
   dosage of, 82, 130t, 133t
   starting, 124
   frequency of prescriptions for, 138t
   indications for, 148t
   potency of, 85
   STEPS criteria for, 109t
   withdrawal from, 102
Clarithromycin, 92t
Classic major depression. See Melancholic depression.
Clomipramine (Anafranil)
   action mechanism of, 58t-59t
   CYP enzymes and, 90t-91t
   dosage of, 130t, 132t-133t
   efficacy of, acute, 121
   STEPS criteria for, 107t
Clonazepam
   antidepressants with, 207-208
   CYP enzymes and, 92t
Clozapine, 90t, 92t
Cocaine, 17, 92t
Codeine, 91t
Communicating with patient
   about and during antidepressant drug therapy, 47-50, 54-55, 55t, 172-173
   educating about depression, 46
   to initiate outpatient therapy, 43-48
   typical patient questions about, 43t
   psychosis assessment in, 42
   questions to ask in diagnosis, 29, 32-33
   suicide risk assessment in, 39-42, 40t
   terminology for depressed mood in, 37t
Concentration/attention, 13, 14t
   in different types of affective disorders, 16t
   in workplace, 23
Confusion, 194-195
Constipation, 195
Cortisol, 92t
Cost of antidepressants, 124-125, 126t-129t
Counseling
   medication with, 45
   psychotherapy as, 45-46
Cyclosporine, 92t
Cyproheptadine (Periactin), 195, 199
Cytochrome P450 enzymes, drug interactions with, 80, 87, 107t-114t, 117, 150-151
   dopamine and norepinephrine reuptake inhibitors, 166
   mixed reuptake and neuroreceptor antagonists, 184-186
   molindone, 187
   norepinephrine selective reuptake inhibitors, 143, 145
   oxidative drug metabolism and, 87-88, 90t-93t, 99t
   serotonin and norepinephrine reuptake inhibitors, 153, 156
   serotonin selective reuptake inhibitors, 147, 151-152, 185-186
   serotonin 2A receptor blockade and weak serotonin
   reuptake inhibitors, 159-161
   symptoms of, 183-184
   testing for, 88-89, 96t-98t
Dapsone, 92t
Death. See also Suicide.
   accidental, depression-related, 21
Debrisoquine, 91t
Dehydro-3-epiandrosterone, 92t
Desipramine (Norpramin)
   action mechanism of, 58t-59t, 62t-63t, 83t
   action site of, 80, 81
   acute therapeutic index of, 106
   adverse effects of, 198
   cost of, 126t
   CYP enzymes and, 91t
   dosage of, 130t, 132t-133t
   starting, 124
   drug interactions with, 108t
   frequency of prescriptions for, 138t
   hypertension from, 115
   sexual dysfunction and, 119
   STEPS criteria for, 108t
N-Desmethylcitalopram, 91t
O-Desmethylvenlafaxine, 91t
Desyrel. See Trazodone.
Dexamethasone, 92t
Dextroamphetamine, 203-204
Dextromethorphan, 91t
Diabetes mellitus, 182t
Diagnosis of depression. See also Communicating with
patient.
   algorithm for, 30-31
   bipolar vs unipolar, 16t, 17-18
   categories of, 12
   critical variables in, 12t
   differential, 17
DSM-IV criteria for, 13, 14t-15t
   duration of symptoms in, 14t, 15t
   family history in. See Family history.
   laboratory tests in, 27, 30, 33, 37
   medical conditions in, 14t, 15t, 27, 38
   pathophysiology in, 17, 33
   patient behavior in, 34t-35t, 36
   patient self-descriptions in, 37t
   in primary-care setting, 27-28
   questions to ask patient in, 29, 32-33
   signs and symptoms in, 13, 16t, 27-28
   duration of, 298
   steps in, 28-29, 30-31
Diagnostic and Statistical Manual IV (DSM-IV),
   depression criteria in, 13, 14t-15t
Diaphoresis, 195
Diarrhea, 195
Diazepam, 90t, 92t
Diltiazem, 92t
Disopyramide, 91t
Dizziness, 195-196
Docetaxel, 92t
Dopamine, 17
Dopamine agonists, 203-204
Dopamine and norepinephrine reuptake inhibitors. See
also specific drugs.
   action mechanism of, 58t-59t, 62t-63t
   advantages of, 164-165
   cost of, 129t
   disadvantages of, 165-167
   dosage of, 131t-132t
   drug interactions with, 166-167
   frequency of prescriptions for, 138t
   seizure risk with, 165, 167
   STEPS criteria for, 113t, 164-167
Dopamine uptake pump, 67t
Doxepin (Sinequan)
   action mechanism of, 58t-59t
   cost of, 126t
   dosage of, 130t, 132t-133t
   frequency of prescriptions for, 138t
   STEPS criteria for, 107t
Drowsiness, 196-197
Dry mouth, 197
Effexor. See Venlafaxine.
Efficacy of drug therapy. See Antidepressant drug
therapy, efficacy of.
Elavil. See Amitriptyline.
Elderly population
   antidepressant dosage for, 130t-131t
   antidepressant drug therapy in, other medications with,
179, 181, 182t
   as risk group for depression, 17
Electroconvulsive therapy, 17, 209
Encainide, 91t
Energy, in different types of affective disorders, 16t
Epilepsy, 182t
Erex (yohimbine), 199
Erythromycin, 92t
Estradiol, 92t
Estrogen
   CYP enzymes and, 92t
   depression and, 25
Ethinylestradiol, 92t
Ethosuximide, 91t
Ethylmorphine, 91t
Family dysfunction, depression-related, 24, 35t. See also
Marriage.
Family history
   in atypical major depression, 15
   in classic major depression, 15, 24, 36
   bipolar, 18, 36
   unipolar, 22t
   of suicide, 40
Fast Na+ channel blockade
   drugs for, 62t-63t
   physiological consequences of, 66t, 83
   TATCA effect on, 116
Fatigue, 13, 14t, 27, 197-198
Felodipine, 92t
Financial problems, 28
Flecainide, 91t
Fluoxetine (Prozac)
   action mechanism of, 58t-59t
   adverse effects of, 68t-71t, 76t
   cost of, 127t
   CYP enzymes and, 91t, 94t, 96t, 115, 117, 150-151
   dosage of, 82, 130t, 133t
   starting, 124
   drug interactions with, 150-152, 184-186, 188-189
   frequency of prescriptions for, 137, 138t   
   half-life of, 99-100
   indications for, 148t
   potency of, 85
   STEPS criteria for, 109t   
   withdrawal from, 102
FLUSH mnemonic, 101t
Fluvoxamine (Luvox)
   adverse effects of, 68t-71t, 76t
   cost of, 127t
   CYP enzymes and, 94t, 96t, 117, 150
   dosage of, 82, 131t-133t
   starting, 124
   drug interactions with, 150-151
   narcotics, 189-191
   frequency of prescriptions for, 138t
   half-life of, 95
   indications for, 148t
   potency of, 85
   STEPS criteria for, 109t
   withdrawal from, 102, 150
Four “D’s” of antidepressants, 40-51, 54
Gender differences
   in alcohol intake, 25-26
   in suicide risk, 40t
Guilt feelings, 14t, 40, 43
Half-life, clinical importance of, 95, 99-100
Haloperidol, 91t
Hamilton Depression Rating Scale, 33t
Head carcinoma, 17
Headache, 27
Hepatic impairment, 130t-131t
Hexobarbital, 90t
Histamine-1 receptor blockade
   drugs for, 62t-63t
   physiologic consequences of, 67t, 107t, 195
   TATCA effect on, 116
Hospitalization, 42-43
Human immunodeficiency virus infection, 180t
4-Hydroxyamphetamine, 91t
Hyperphagia, 198
Hypersomnia, 14t
Hypertensive crisis, 67t, 116-117
Hypomania, 16t, 18
Imipramine (Tofranil-PM)
   action mechanism of, 58t-59t
   adverse effects of, 72t-75t, 78t
   cost of, 126t
   CYP enzymes and, 90t-91t
Imipramine (continued)
   dosage of, 130t, 132t-133t
   efficacy of, 123
   frequency of prescriptions for, 138t
   indications for, 141-142
   potency of, 86
   STEPS criteria for, 107t
Immunosuppressants, 92t
Insomnia, 14t, 27, 198
Irritability, 14t, 27, 36
Laboratory testing, in diagnosis of depression, 27, 30, 33, 37
Lidocaine, 91t-92t
Lithium, antidepressants with, 18, 36, 203, 208-209
Loratadine, 92t
Lovastatin, 92t
Ludiomil. See Maprotiline.
Luvox. See Fluvoxamine.
Macrolide antibiotics, 92t
Manic episode, 18
Manic-depressive disorder
   family history of, 18
   signs and symptoms of, 16t, 17-18
Maprotiline (Ludiomil)
   action mechanism of, 58t-59t
   dosage of, 130t, 132t
   hypertension from, 115
   STEPS criteria for, 108t
Marriage
   depression effect on, 24, 28
   suicide risk and, 40t
Medical history, 27, 30, 33
Medical illness
   with depression, 14t, 15t, 27, 38
   suicide risk and, 40t
Medications, as cause of depression, 33
Melancholic depression
   family history of, 15, 24
   onset age in, 15, 24
   signs and symptoms of, 13, 16t
Memory problems, 27
Menopause, 24-25
Mephenytoin, 90t
Mephobartibal, 90t
Methadone, 90t
Methylphenidate, 203-204
Metoprolol, 91t
Mexiletine, 91t
Mibefradil (Posicor), 88
Midazolam, 92t
Minodipine, 92t
Mirtazapine (Remeron)
   action mechanism of, 58t-59t, 62t-64t, 77, 80, 161
   advantages of, 162
   adverse effects of, 72t-75t, 78t, 196-198
   for anorexia, 195
   cost of, 129t
   disadvantages of, 163-164
   dosage of, 131t-132t
   ascending, 135
   starting, 124, 134
   efficacy of, acute, 121
   frequency of prescriptions for, 138t
   potency of, 86
   sexual dysfunction and, 119
   STEPS criteria for, 112t, 162-163
Mixed reuptake and neuroreceptor antagonists. See also
Monoamine oxidase inhibitors; Tertiary amine
tricyclic antidepressants.
   action mechanism of, 58t-59t, 62t-63t
   disadvantages of, 140-142
   dosage of, 130t, 132t-133t
   frequency of prescriptions for, 138t
   history of, 139
   indications for, 142-143
   STEPS criteria for, 107t, 140-142
Molindone
   CYP enzymes and, 91t
   drug interactions with, 186
Monoamine oxidase inhibitors
   action mechanism of, 59t, 63t
   advantages of, 168-169
   cost of, 129t
   disadvantages of, 168
   dosage of, 131t-132t
Monoamine oxidase inhibitors (continued)
   drug interactions with, 67t, 84, 168
   frequency of prescriptions for, 138t
   physiological consequences of, 67t, 117
   STEPS criteria for, 114t, 140-141
Mood stabilizers, 208-209
Mood symptoms, 13, 14t, 27
   in different types of affective disorders, 16t
Motivation, 13
Muscarinic acetylcholine receptor blockers
   adverse effects of, 195, 197
   drugs for, 62t-63t
   physiologic consequences of, 67t, 107t
   TATCA effect on, 116
   withdrawal from, 100t, 100-101
Myocardial infarction, 182t
Myths about depression, 11
Narcotics, fluvoxamine interaction with, 189-191
Nardil (phenelzine), 129t
Nausea, 198-199
Nefazodone (Serzone)
   action mechanism of, 58t-59t, 62t-63t, 77, 83t
   action site of, 80
   adverse effects of, 72t-75t, 78t, 196, 200
   cost of, 128t
   CYP enzymes and, 91t, 94t, 157, 159-160
   dosage of, 131t-133t, 158
   ascending, 135
   frequency of, 135
   frequency of prescriptions for, 138t
   half-life of, 95, 102
   indications for, 160
   pharmacokinetics of, 159-160
   potency of, 86
   sexual dysfunction and, 119
   STEPS criteria for, 111t
   withdrawal from, 102-103
Nervousness, 199
Nicardipine, 92t
Nifedipine, 92t
Niludipine, 92t
Nisoldipine, 92t
Nitrendipine, 92t
Norepinephrine, 17, 25
Norepinephrine selective reuptake inhibitors, 62t-63t. See
   also specific drugs.
   action mechanism of, 58t-59t, 62t-63t, 67t, 119
   action site of, 62t, 66t
   adverse effects of, 198
   cost of, 126t-127t
   dosage of, 130t, 132t-133t
   starting, 124
   drug interactions with, 67t
   efficacy of, 121-122
   frequency of prescriptions for, 138t
   hypertension from, 115
   physiological consequences of, 66t, 195
   STEPS criteria for, 108t, 144-145
Norpramin. See Desipramine.
Nortriptyline (Pamelor, Aventyl)
   action mechanism of, 58t-59t
   cost of, 126t
   dosage of, 130t, 132t
   starting, 124
   frequency of prescriptions for, 138t
   hypertension from, 115
   STEPS criteria for, 108t
Occupational impairment, 15t, 23-24, 28, 43
Olanzapine, 90t
Omeprazole, 92t
Onset age. See Age.
Opiates, 90t-91t
Paclitaxel, 92t
Pain, chronic, 182t
Pamelor. See Nortriptyline.
Pancreatic carcinoma, 17
Paracetamol, 90t
Parkinson’s disease
   bupropion for, 167-168
   depression with, 182t, 204
   drug interactions in, 186-188
Parnate. See Tranylcypromine.
Paroxetine (Paxil)
   action mechanism of, 58t-59t
   adverse effects of, 68t-71t, 76t
   cost of, 127t
   CYP enzymes and, 91t, 94t, 97t, 102, 150-151
   dosage of, 82, 131t-133t
   starting, 124
   drug interactions with, 150-151, 187
   frequency of prescriptions for, 137, 138t
   indications for, 148t
   potency of, 85
   STEPS criteria for, 109t
   withdrawal from, 102, 150
Patient education
   about antidepressant drug therapy, 47-48, 54-55, 55t
   about depression, 46-47
Paxil. See Paroxetine.
Perhexiline, 91t
Periactin (cyproheptadine), 199
Perphenazine, 91t
Phenelzine (Nardil), 129t
Phenformin, 91t
Phenytoin, 90t, 188-189
Pindolol, 204
Placebo response, 53t, 53-54
Posicor (mibefradil), 88
Postpartum depression, 24-25
Prazosin, 83t
Prevalence of depression, 11, 21
   cost of, to employers, 23
   recurrent, 21, 46-48
   unipolar, 22t
Priapism, 119
Primary-care setting in depression
   diagnosis in, 27-28. See also Diagnosis of depression.
   management in, 11-12
Progesterone, 92t
Prognosis of depression, 26
Propafenone, 91t
Propranolol, 90t-91t
Protriptyline (Vivactil)
   action mechanism of, 58t-59t
   hypertension from, 115
   STEPS criteria for, 108t
Prozac. See Fluoxetine.
Psychomotor agitation or retardation, 14t
Psychomotor restlessness, 36
Psychosis assessment, 42
Psychostimulants, 203-204
Psychotherapy
   medication with, 45
   necessity for, 45-46
Quetiapine, 92t
Quinidine
   action mechanism of, 83t
   CYP enzymes and, 91t
Rational thinking, suicide risk and, 40t
Recurrence of depression
   frequency of, 21
   patient education about, 46-48
   unipolar, 22t
Remeron. See Mirtazapine.
Renal impairment
   antidepressant dosage in, 130t-131t
   depression with, 182t
Responsiveness of patient, in diagnosis of depression, 34t, 36
Reuptake and neuroreceptor antagonists
   action site of, 62t, 66t
   physiological effects of, 66t
Risk groups for depression, 17
Risperidone, 91t
Rule of seven, 23t
SAD PERSONS scale, 40t
Safety, in antidepressant drug therapy, 105-106, 106t-114t, 115-118
Secondary amine tricyclic antidepressants (SATCAs),
143. See also Desipramine.
   action mechanisms of, 143-144
   advantages of, 144-146
   disadvantages of, 146
   history of, 143
   STEPS criteria for, 144-146
Seizures, 119, 165, 167, 188-189
Seldane (terfenadine), 88
Self-esteem, 27
Serotonin, 17
   estrogen and, 25
Serotonin and alpha-2 norepinephrine receptor blockers. See also specific drugs.
   action mechanism of, 58t-59t, 62t-63t, 161
   advantages of, 162
   cost of, 129t
   disadvantages of, 163-164
   dosage of, 131t-132t
   frequency of prescriptions for, 138t
   STEPS criteria for, 112t, 162-163
Serotonin and norepinephrine reuptake inhibitors. See also
specific drugs.
   action mechanism of, 58t-59t, 62t-63t, 156
   action site of, 77
   advantages of, 153-155
   availability of, 153
   cost of, 128t
   disadvantages of, 155-156
   dosage of, 131t-133t
   drug interactions with, 153
   frequency of prescriptions for, 138t
   hypertension from, 115
   STEPS criteria for, 110t, 153-155
   withdrawal from, 155
Serotonin receptor blockers
   drug interactions with, 67t
   drugs for, 62t-63t
   physiological consequences of, 66t
Serotonin selective reuptake inhibitors. See also specific
drugs.
   action mechanism of, 58t-59t, 62t-63t
   action site of, 77
   advantages of, 146, 149
   cost of, 127t
   disadvantages of, 149-152, 194-196, 200
   dosage of, 125, 130t-133t, 134-135
   drug interactions with, 150-151, 184-190
   efficacy of, 121-122, 149
Serotonin selective reuptake inhibitors (continued)
   frequency of prescriptions for, 137, 138t
   indications for, 148t
   sleep disturbances with, 197-198
   STEPS criteria for, 109t, 147, 149
   withdrawal from, 100-101, 101t, 150
Serotonin syndrome, 67t, 84, 109t, 117, 150
Serotonin-2A receptor blocker and weak serotonin uptake
inhibitors. See also specific drugs.
   action mechanism of, 58t-59t, 62t-63t
   advantages of, 157
   cost of, 128t
   CYP enzymes and, 159-161
   disadvantages of, 157-161, 195
   dosage of, 131t-133t
   drug interactions with, 157
   frequency of prescriptions for, 138t, 156-157
   pharmacokinetics of, 159
   STEPS criteria for, 111t, 157-159
Sertraline (Zoloft)
   action mechanism of, 58t-59t, 62t-63t, 83t
   action site of, 80, 81
   advantages of, 152
   adverse effects of, 68t-71t, 76t
   cost of, 127t
   CYP enzymes and, 91t, 94t, 97t
   dosage of, 82, 131t, 133t
   frequency of prescriptions for, 138t
   indications for, 12, 148t
   potency of, 85
   STEPS criteria for, 109t
   withdrawal from, 102
Serzone. See Nefazodone.
Sex drive, 13
   in different types of affective disorders, 16t
Sexual dysfunction, 199
   antidepressant-induced, 118-119
Sildenafil (Viagra), 197
Sinequan. See Doxepin.
Sleep patterns, 13, 14t, 27
   in different types of affective disorders, 16t
Social history, in diagnosis of depression, 30, 33
Social withdrawal/isolation, 15t, 28, 35t
   suicide risk and, 40t
Sodium channel. See Fast Na+ channel blockade.
Somatization disorder, 36
Sparteine, 91t
   STEPS (safety-tolerability-efficacy-payment-simplicity) criteria, 50, 105, 106t
   for dopamine and norepinephrine reuptake inhibitors, 113t, 164-167
   for mixed reuptake and neuroreceptor antagonists, 107t, 140-141
   for monoamine oxidase inhibitors, 114t, 140-141
   for norepinephrine selective reuptake inhibitors, 108t, 144-145
   for serotonin and alpha-2 norepinephrine receptor
   antagonists, 112t, 162-163
   for serotonin and norepinephrine reuptake inhibitors, 110t, 153-155
   for serotonin selective reuptake inhibitors, 109t, 147, 149
   for serotonin-2A receptor antagonists and weak serotonin
   reuptake inhibitors, 111t, 157-159
   for TATCAs, 140-141
Steroids, 92t
Stress tolerance, 34t, 43
Stroke, 182t, 204
Substance abuse in depression
   as cause, 17, 33
   as symptom, 15t, 21, 23
Suicide, 21
   ideation involving, 14t, 41-42
   incidence of, 21
   previous attempts at, 39, 40t
   risk of, 39-42, 40t, 184-186
   rule of seven in, 23t
   SAD PERSONS scale in, 40t
   in unipolar disorder, 22t
Surmontil (trimipramine), 58t-59t
Tacrine, 90t
Tacrolimus, 92t
Tamoxifen, 92t
TATCAs. See Tertiary amine tricyclic antidepressants.
Terfenadine (Seldane), 88, 92t
Tertiary amine tricyclic antidepressants (TATCAs). See
also specific drugs.
   action sites and mechanisms of, 80, 81, 82
   acute therapeutic index of, 105-106, 115
   advantages of, 140
   adverse effects of, 83-84
   cost of, 126t
   disadvantages of, 141-142
   dosage of, 141-142
   monitoring of, 134
   drug interactions with, 116-117
   efficacy of
   acute, 121
   prophylactic, 123
   frequency of prescriptions for, 138t, 139
   indications for, 141-142
   lethality of, 83
   pharmacology of, 82-83
   sexual dysfunction and, 119
   STEPS criteria for, 140-142
Testosterone, 92t
Theophylline, 90t
Thioridazine, 90t, 91t
Thyroid supplementation, as augmentation strategy, 203
Timolol, 91t
Tofranil-PM. See Imipramine.
Tolbutamide, 90t
Tolerability, in antidepressant drug therapy, 118-119
Tranylcypromine (Parnate)
   action mechanism of, 62t
   cost of, 129t
   STEPS criteria for, 114t
Trazodone (Desyrel)
   action mechanism of, 58t-59t, 80
   cost of, 128t
   dosage of, 131t-133t
   frequency of prescriptions for, 138t
   priapism from, 119
   STEPS criteria for, 111t
Treatment of depression. See also Antidepressant drug
therapy.
   advances in, 26
   communicating with patient in. See Communicating with
   patient.
   hospitalization decision in, 42-43
   initiating outpatient therapy in, 43t, 43-48
   response vs remission in, 52, 53t
   timing of, 38
Triacetyloleandomycin, 92t
Triazolam, 92t
Tricyclic antidepressants. See also Tertiary amine
tricyclic antidepressants (TATCAs).
   acute therapeutic index of, 106
   cardiac toxicity of, 118
   drug interaction with, 184-186
Trimipramine (Surmontil), 58t-59t
Unipolar disorder
   duration of, 22t
   prevalence of, 18, 22t
   recurrent, 22t
   suicide in, 22t
vs bipolar disorder, 16t, 17
Valproate, 208-209
Venlafaxine (Effexor)
   action mechanism of, 58t-59t, 62t-63t, 156
   action site of, 77, 80
   advantages of, 153-155
   adverse effects of, 72t-75t, 78t, 135, 194, 196, 199
   cost of, 128t
   CYP enzymes and, 91t, 94t
   disadvantages of, 155-156
   dosage of, 131t-133t
   ascending, 135
   starting, 124
   drug interactions with, 153
   efficacy of, 121
   frequency of prescriptions for, 138t
   half-life of, 95, 155
   hypertension from, 115
   potency of, 86
   STEPS criteria for, 110t, 153-154
   withdrawal from, 102, 155
Verapamil, 92t
Viagra (sildenafil), 197
Visual disturbance, 200
Vivactil. See Protriptyline.
Warfarin, 90t
Weight changes, 13, 14t, 27
   in children, 14t
   in malignancies, 17
Wellbutrin. See Bupropion.
Workplace, 15t, 23-24, 28, 43
Worthlessness feelings, 14t
Yocon (yohimbine), 83t, 199
Yohimbine (Aphrodyne, Erex, Yocon, Yohimex), 83t, 199
Yohimex (yohimbine), 83t, 199
Zoloft. See Sertraline.
Zung Depression Self-Report Rating Scale, 176-177, 177
Zyban. See Bupropion.