By vgreene, 5 October, 2020 Acupuncture Consider adding acupuncture to antidepressant meds if psychotherapy pharmaco tx exercise St John s wort mono tx aren t acceptable available per APA 1 VA says insufficient evidence for acupuncture as adjunct 2 APA says insufficient evidence for
By vgreene, 5 October, 2020 St John s wort Hypericum perforatum mono tx Avoid if pregnant breastfeeding 2 Adverse effects mild GI sx skin reactions dizziness confusion etc consider herb drug interactions esp w antidepressants warfarin oral contraceptives antiretroviral anti cancer a
By vgreene, 5 October, 2020 If psychotherapy pharma co tx options are ineffective unacceptable consider the following options for managing mild mod MDD 1
By vgreene, 5 October, 2020 If other strategies failed d t significant side effects 4 consider atypical antipsychotics Monitor glucose CBC hepatic panel lipid panel BMI waist circumference BP involuntary movements tardive dyskinesia 2 aripiprazole Monitor for akathisia wt uarr fatig
By vgreene, 5 October, 2020 If hypothyroid consider liothyronine synthetic T3 50 mcg day per VA 2 25 50 mcg day per ICSI 4 Caution in pts w CV dz arrhythmias DM renal impairment untreated adrenal insufficiency2
By vgreene, 5 October, 2020 Buspirone Dose bid or tid start 15 mg day x1wk increase to 30 mg day x1 2wk then 45 mg day at wk 4 Max dose 60 mg day 2 4wk for efficacy2
By vgreene, 5 October, 2020 Bupropion contraindicated in pts w sz disorder hx of anorexia nervosa or bulimia May uarr anxiety2
