Treatment of Major Depression

TREATMENT OF MAJOR DEPRESSION

It is often surprising for the student to learn that mood-elevating agents do not act as stimulants of the central nervous system (CNS). With the exception of varying degrees of sedation, the antidepressants have little ef-fect on behavior early in treatment. During this period patients will, however, have side effects specific to the class and agent being used. Only after 2 to 3 weeks of dosing will a therapeutic benefit on depression emerge. At this point the patient begins to demonstrate eleva-tion in mood and self-esteem. In addition, many of the vegetative signs of the illness (e.g., insomnia, anorexia) abate, and the patient regains an interest in daily activi-ties. Failure to continue the medication, however, will result in an immediate relapse into the depressive state. Therefore, maintenance therapy must be continued for at least 6 months.