Psychosomatics 39:S2-S19, June 1998
© 1998 The Academy of Psychosomatic Medine
Psychopharmacologic Treatment of Depression in the Medically Ill
Karen Beliles, M.D., and
Alan Stoudemire, M.D.
Received March 30, 1997; revised November 26, 1997; accepted January 26, 1998. From the Department of Psychiatry, Creighton and Nebraska Universities Schools of Medicine, Omaha, Nebraska; and the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Address reprint requests to Dr. Beliles, Department of Psychiatry, Creighton/Nebraska Universities, 600 S. 42nd Street, Box 985575, Omaha, NE 68198–5575.
Appropriate selection of an antidepressant agent in medically ill patients requires a careful risk–benefit assessment matching the pharmacokinetic and pharmacodynamic properties of the drug being considered against the patient's physiological vulnerabilities, potential for drug interactions, and primary symptoms of the patient's depression. While in the past antidepressant drug selection was limited by the almost sole availability of the tricyclic antidepressants, newer drugs such as selective serotonin reuptake inhibitors, bupropion, and venlafaxine have vastly simplified treating depression in the medically ill. In refractory cases of depression in patients with medical illness, electroconvulsive therapy can be used with appropriate anesthetic management.
Key Words: Psychopharmacology • Literature Review • Depression • Medically Ill • Supplement • Antidepressants
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