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Antidepressants

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Clinical Psychopharmacology for Neurologists

Abstract

Identifying and treating depression are integral to the care of the neurology patient. First-line, evidence-based treatments for depression include antidepressant medication and depression-focused psychotherapy. All antidepressants are considered equally effective; therefore most clinicians select an agent based upon its side effect and safety profile. An antidepressant must be given at its therapeutic dose for 4–6 weeks before determining whether it is working. Escitalopram and sertraline are well-tolerated SSRIs with few drug-drug interactions. Common side effects of antidepressants include nausea, feeling jittery, weight gain, and sexual dysfunction. Clinicians should be vigilant for less common but more worrisome events such as treatment-emergent akathisia, suicidality, or a hypomanic or manic episode. The use of antidepressants in specific neurological illnesses is also discussed. Self-report scales for measuring treatment responses are reviewed.

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  1. Department of Psychiatry, Methodist Healthcare Systems, San Antonio, TX, USA

    Leigh Jennings MD

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  1. Professor & Director, Division of Geriatric Psychiatry, Department of Psychiatry & Behavioral Neuroscience, St. Louis University School of Medicine, St. Louis, Missouri, USA

    George T. Grossberg

  2. Co-Director of Neurology, SSM Neuroscience Institute, St. Louis, Missouri, USA

    Laurence J. Kinsella

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Jennings, L. (2018). Antidepressants. In: Grossberg, G., Kinsella, L. (eds) Clinical Psychopharmacology for Neurologists. Springer, Cham. https://doi.org/10.1007/978-3-319-74604-3_4

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