The duration of depression is usually recurring and continual, so psychopharmacologic treatment usually includes three phases: the preliminary heightened period, the persistence period, and the effect-keeping phase that prevent the return of illness. The first and second phases are normally held for three months each. Treatment maintenance is very important for recurring illnesses. Its duration is dependent on many factors and can’t be exactly determined without careful examination of the case.
Not every patient is at risk of illness recurring, thus treatment duration varies from 6-9 months to 4-5 years. The dosage of medicine for efficient effect maintenance is usually the same as during the first two stages of treatment. Also the effect is dependent of antidepressant chosen. Saxena PR. (1995) wrote: …. future drug development should aim at producing antidepressants that work faster. Preliminary evidence suggests that targeting subtype receptors—for example, by using a combination of a blocker of the 5HT autoceptor such as pindolol, and an SSRI—may accelerate the antidepressant response (p. 15).
This again testifies that newly developed antidepressants can decrease the duration of treatment and help disprove the rather widespread opinion that mental diseases are incurable. The cost of treatment With the development of medical care financial plans which need high expenses, significant attention must be paid to the cost-effective assessment of medicines for depression treatment. At the same time as further investigation of this significant issue is still necessary, researches approved new antidepressants as improving the state of the patients and bringing them to normal life.
The application of old medicines instead of SSRIs only because they are not so expensive is not supported by medicine, because at the same time as the SSRIs costs more it is proved that patients finally spend less money due to their better effect and no dependence. TCA medicines can have side effects that generate many complications. Consequently a patient has to visit his doctor more often that results in additional costs. Conclusion The popularity of psychopharmacologic treatment of depression with newly-developed and secure medicines is growing.
Notwithstanding that TCAs are still applied, particularly for serious cases of illness, high risk of applying TCA treatment in people who are inclined to self-murder, as well as improvement of rights and opportunities of the patients completely change the model of antidepressant application (Settle EC. , 1998). For many countries it is necessary to estimate the cost- efficiency of newly developed medicines in comparison to the medicines applied before, taking into account the cost of the whole process of treatment with all possible side effects and complications (Desjarlais R, Eisenber L, Good B, et al.38).
If the authorities do not pay proper attention to the serious danger of mental illnesses – especially depression as it is met very often in the modern society—a difficult situation in the field of psychopharmacological therapy will exist. ?
Anderson IM. (1998). SSRI versus tricyclic antidepressants in depressed in-patients: a meta analysis of efficacy and tolerability. Oxford: Oxford University Press; Desjarlais R, Eisenber L, Good B, et al. (1995). World Mental Health: Problems and priorities in low income countries.
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