By switaschek, 16 October, 2020 D C screening if darr life expectancy due to health condition1 3 5 or pt unable unwilling to undergo curative tx 2 3 5
By vgreene, 16 October, 2020 <b>Paroxetine</b> not recommended as 1st-line; assoc w/ increased risk of major & cardiac malformations, unless pt already on paroxetine & has planned pregnancy. Weigh risks of paroxetine against d/c risks<sup>ICSI</sup>
By switaschek, 16 October, 2020 Discuss risks benefits including consequences of false ongoing annual screening employ shared decision making before ordering screen 2 4 6
By vgreene, 16 October, 2020 <b>2nd-gen antidepressant use during pregnancy</b> may be assoc w/ small increase in risk of preeclampsia, postpartum hemorrhage, miscarriage, perinatal death, preterm birth, serotonin withdrawal syndrome, resp distress, pulm hypertension, major & cardiac
By vgreene, 16 October, 2020 <b>Paroxetine</b> not recommended as 1st-line; assoc w/ increased risk of major & cardiac malformations, unless pt already on paroxetine & has planned pregnancy. Weigh risks of paroxetine against d/c risks<sup>ICSI</sup>
By vgreene, 16 October, 2020 <b>2nd-gen antidepressant use during pregnancy</b> may be assoc w/ small increase in risk of preeclampsia, postpartum hemorrhage, miscarriage, perinatal death, preterm birth, serotonin withdrawal syndrome, resp distress, pulm hypertension, major & cardia
By vgreene, 16 October, 2020 <b>If pt ≥65 yo:</b> TCAs such as nortriptyline most effective<sup>ICSI</sup>
By vgreene, 16 October, 2020 Assess pt's recurrence risk & modify tx as needed; after initiation/change of tx, monitor pt monthly until pt achieves remission;<sup>VA</sup> if pt achieves remission (PHQ-9 ≤4 x1mo): Continue antidepressant @ therapeutic dose at least 6mo to ↓relap
