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Improving Diagnosis & Treatment Strategies for Major Depressive Disorder
Major depression is a treatable cause of pain, suffering, disability and death, yet primary care clinicians detect major depression in only one-third to one-half of their patients with major depression. In 2010, The World Health Organization (WHO) released date from their study of depression and mental disorders in the United States and found that MDD accounts for 8.31 percent of US years lived with disability (YLDs). YLDs are the prevalence of MDD times the short- or long-term loss of health. To help put this in perspective, anxiety disorders, the second highest YLDs, account for 5.09%, with drug use disorders accounting for 3.53%. MDD also accounts for 3.7 percent of all US disability-adjusted life years (DALYs), that being the total number of years lost to illness, disability, or premature death. While drug use disorders account for 2.61% and anxiety disorders account for 2.28%. Comorbidities or complications that may arise from MDD include alcohol abuse or substance abuse, stroke, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide.

Major depression disorder can be effectively treated and allow the patient to live without debilitating depression. Newer antidepressant medications have been shown to effectively decrease the symptoms of MDD. Treatment is based on severity of depression, and episode types. Treatment may be multi-faceted, combining medication with psychotherapy. Treatment may change several times as different medications affect people in different ways. Treatment may start with a selective serotonin reuptake inhibitor (SSRI), but if there is no effect, or if the side effects are adverse enough to affect patient adherence, then treatment may change to a serotonin and norepinephrine reuptake inhibitor (SNRI) or a norepinephrine and dopamine reuptake inhibitor (NDRI). Some effective treatments, specifically antidepressants, are currently limited by factors that affect treatment adherence and bring about different side-effects. Recent data showing antidepressant combinations with different mechanisms of action can be a better strategy prior to augmentation with other drug classes. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy.
Physician, Nursing and CMCN credits valid to August 1, 2018
 
Identification and Treatment of Major Depressive Disorder
Major depressive disorder (MDD) is treatable and the earlier treatment starts, the better the outcomes. More than 80% of patients with depression have a medical comorbidity and recent studies show that prolonged depression may raise the risk of stroke and type 2 diabetes. Isolation, personal conflicts, an increase in the use of alcohol or substance abuse and an chance of suicide are also a major concern. These studies show the importance of using approved evidence-based guidelines to choose an appropriate treatment management plan. MDD can be effectively treated and allow the patient to live without debilitating depression as there are several different treatment programs; usually medication and psychotherapy are effective. Newer antidepressant medications have been shown to effectively decrease the symptoms of MDD. Some effective treatments, specifically antidepressants, are currently limited by factors that affect treatment adherence and bring about different side-effects. Recent data showing antidepressant combinations with different mechanisms of action can be a better strategy prior to augmentation with other drug classes. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy.
Physician, Nursing and CMCN credits valid to January 31, 2018