By vgreene, 4 October, 2020 CT, BT/BA, CBT, IPT, MCBT, PST are 1st-line, evidence-based psychotherapy options
By vgreene, 4 October, 2020 Refer for psychotherapy (CBT ACP and non-CBT therapies); evidence generally doesn't favor 1 specific psychotherapy model vs another;APA,ACP,VA however, ACP says to offer computer-based CBT as 1st-line if pt prefers, or as adjunctive tx;ACP offer individua
By vgreene, 4 October, 2020 Refer for psychotherapy (CBT ACP and non-CBT therapies); evidence generally doesn't favor 1 specific psychotherapy model vs another;APA, ACP, VA however, ACP says to offer computer-based CBT as 1st-line if pt prefers, or as adjunctive tx;ACP offer individ
By vgreene, 4 October, 2020 Refer for psychotherapy (CBT ACP and non-CBT therapies); evidence generally doesn't favor 1 specific psychotherapy model vs another;APA, ACP, VA however, ACP says to offer computer-based CBT as 1st-line if pt prefers, or as adjunctive tx;ACP offer individ
By vgreene, 4 October, 2020 Offer SSRIs (except fluvoxamineVA):ACP, APA, VA citalopram, escitalopram, fluoxetine, paroxetine, sertraline, vilazodone; SNRIs:ACP, APA, VA duloxetine, venlafaxine, venlafaxine XR, desvenlafaxine, levomilnacipran; SSNRIs;ACP atypical antidepressants: bup
By vgreene, 4 October, 2020 Caution pts to watch closely for worsening depression/unusual behavior, esp in first few wks of starting new med or changing dosage; young adults
By vgreene, 4 October, 2020 Consider bupropion for pts who desire to stop smoking. Contraindicated in pts w/ SZ disorder, hx of anorexia nervosa or bulimia. Bupropion can also worsen anxiety
By vgreene, 4 October, 2020 Note that bupropion is assoc w/ ↓rate of sexual adverse events than fluoxetine and sertraline, whereas paroxetine has ↑rates of sexual dysfunction than fluoxetine, fluvoxamine, nefazodone, and sertralineACP
