Depression is common in physically ill populations, although it is frequently unrecognized and untreated. Diagnosis and antidepressant treatment are discussed. The side-effect profiles of the selective 5-HT re-uptake inhibitors suggest they may offer new therapeutic opportunities in physically ill patients. Sertraline may be of particular benefit in some patients due to its distinct pharmacological profile and the potential for fewer drug interactions. Further evaluation is necessary to determine the risk-benefit ratio for drugs of this class.
Altamura A., Montgomery S., Wernicke J. (1988) The evidence for 20 mg of fluoxetine as the optimal in the treatment of depression. Br J Psychiatr153 (Suppl 3): 109-112
3.
Amin M., Lehmann H., Mirmiran J. (1989) A double-blind, placebo-controlled, dose-finding study with sertraline. Psychopharmacol Bull25: 164-167
4.
Baldwin R.C., Jolley D.J. (1986) The prognosis of depression in old age. Br J Psychiatr149: 574-583
5.
Banerjee A.K. (1988) Recovery from prolonged cerebral depression after fluvoxamine overdose. Br Med J296: 1774
6.
Barrett J.E., Barrett J.A., Oxman T.E. et al. (1988) The prevalence of psychiatric disorders in a primary care practice. Arch Gen Psychiatr45: 1100-1106
7.
Bayer A.J., Roberts N.A., Allen E.A. et al. (1989) The pharmacokinetics of paroxetine in the elderly. Acta Psychiatr Scand80 (Suppl. 350): 85-86.
8.
Beasley C.M., Dornseif B.E., Pultz J.A. et al. (1991) Fluoxetine versus trazodone: efficacy and activating-sedating effects. J Clin Psychiatr52: 294-299
9.
Benfield P., Ward A. ( 1986) Fluvoxamine: A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in depressive illness. Drugs32: 313-334
10.
Berken B.H., Weinstein D.O., Stern W.C. (1984) Weight gain: A side effect of tricyclic antidepressants . J Affective Disord7: 133-138
11.
Bernstein J.G. (1988) Psychotropic drug induced weight gain: mechanisms and management. Clin Neuropharmacol11 (Suppl 1): S194-S206
12.
Black D.W., Winokur G., Nasrallah A. (1987) Treatment and outcome in secondary depression: a naturalistic study of 1087 patients. J Clin Psychiatr48: 438-441
13.
Boyer W.F., Feighner J.P. (1991) Pharmacokinetics and drug interactions. In Feighner J P, Boyer W F (eds), Selective serotonin re-uptake inhibitors . Wiley, p. 81
14.
British National Formulary (1992) British Medical Association and the Royal Pharmaceutical Society of Great Britain. Number 23 (March 1992): p. 152
15.
Brosen K., Skelbo E. (1991) Fluoxetine and norfluoxetine are potent inhibitors of P450 II D6—The source of the sparteine/debrisoquine oxidation polymorphism . Br J Clin Pharmacol32: 136-137
16.
Brosen K., Gram L.F., Sindrup S.H. et al. (1992) Pharmacogenetics of tricyclic antidepressants and novel antidepressants : recent developments. Clin Neuropharmacol15: 80A-81A
17.
Brown W.A. (1991) Are patients who are intolerant to one SSRI, intolerant to another? Poster presented at ACNP, San Juan, Puerto Rico, December 9-13th
18.
Cadoret R.J., Widmer R.B., Troughton E.P. (1980) Somatic complaints: Harbinger of depression in primary care. J Affective Disord2: 61-70
19.
Cavanaugh S V A (1983) The prevalence of emotional and cognitive dysfunction in a general medical population: Using the MMSE, GHQ and BDI. Gen Hosp Psychiatr5: 15-24
Cooper G.L. (1988) The safety of fluoxetine—An update. Br J Psychiatr153: 77-86
22.
Cooper S.M., Jackson D., Loudon J.M. et al. (1989) The psychomotor effects of paroxetine and in combination with haloperidol, amylobarbitone, oxazepam, or alcohol. Acta Psychiatr Scand80: 53-55
23.
Costa D., Magos I., Toma T. ( 1985) Efficacy and safety of mianserin in the treatment of depression in women with cancer. Acta Psychiatr Scand72 (Suppl 320): 85-92
24.
Crewe H.K., Lennard M.S., Tucker G.T. et al. (1992) The effect of SSRIs on cytochrome P450 II D6 activity in human liver microsomes. Br J Clin Pharmacol34: 1-4
25.
Danion J.M. (1989) The effectiveness of fluoxetine in acute studies and long-term treatment. In Stefanis C N, Soldatos C R, Rabavilas A D (eds), Psychiatry today: VIII world congress of psychiatry abstractsElsevier, New York, p. 334
26.
Doogan D.P. (1991) Toleration and safety of sertraline: Experience worldwide. Int Clin Psychopharmacol6: 47-56
27.
Doogan D.P., Caillard V. (1992) Sertraline in the prevention of depression. Br J Psychiatr160: 217-222
28.
Dunbar G.C. (1990) The efficacy profile of paroxetine, a new antidepressant, compared with imipramine and placebo. 17th CINP Congress Abstracts1: 17
29.
Edwards J.G., Long S.K., Sedgwick E.M., Wheal H.V. (1986) Antidepressants and convulsive seizures: clinical electroencephalographic and pharmacological aspects. Clin Neuropharmacol9: 329-360
30.
Endicott J. (1984) Measurement of depression in patients with cancer . Cancer53: 2243-2249
31.
Feldman E., Mayou R., Hawton K. et al. (1987) Psychiatric disorder in medical in-patients . Q J Med63: 405-412
32.
Fogel B.S. (1988) Combining anticonvulsants with conventional psychopharmacologic agents. In Clifton N J, McElroy S L, Pope H G (eds), Use of anticonvulsants in psychiatry: recent advances. Oxford Health Care, pp. 77-94
33.
France R.D., Houpt J.L., Ellinwood E.H. (1984) Therapeutic effects of antidepressants in chronic pain. Gen Hosp Psychiatr6: 55-63
34.
Glassman J.N., Dugas J.E., Tsuang M.T. (1985) Idiosyncratic pharmacokinetics complicating treatment of major depression in an elderly woman. J Nerv Ment Dis173: 573-576
35.
Goldberg I.D., Krantz G., Locke Z. (1970) Effect of a short term outpatient psychiatric therapy benefit on the utilization of medical services in a prepaid group practice medical program. Med Care8: 419-426
36.
Goldberg I.D., Bridges K. et al. (1988) Somatic presentations of psychiatric illness in primary care settings. J Psychosom Res32: 137-144
37.
Gram L.F. et al. (1990) Conditions under which genetic polymorphisms are clinically relevant. In Proceedings of the European consensus conference on pharmacogenetics. pp. 89-96
38.
Hindmarch I. (1990) The effects of sertraline on psychomotor performance in elderly volunteers. J Clin Psychiatr51 (12 Suppl B): 34-36
39.
Hoeper E.W., Nycz G., Cleary P.D. et al. (1979) Estimated prevalence of RDC mental disorder in primary care. Int J Mental Health8: 6-15
40.
Johnson A.M. (1991) The comparative pharmacological properties of selective serotonin re-uptake inhibitors in animals. In Feighner J P, Boyer W F (eds), Selective serotonin re-uptake inhibitors. Wiley, p. 37
41.
Jonsson B., Bebbington P.E. (1992) What price depression? The cost and cost effectiveness of pharmacological treatment. Br J Psychiatr (in press)
42.
Katon W. (1984) Panic disorder and somatization: Review of 55 cases . Am J Med77: 101-106
43.
Kaye C.M., Haddock R.E., Langley P.F. et al. (1989) A review of the metabolism and pharmacokinetics of paroxetine in man. Acta Psychiatr Scand80 (Suppl. 350): 60-75
44.
Keller M.B., Lavori P.W., Lewis C.E. et al. (1983) Predictors of relapse in major depressive disorder. J Am Med Assoc250: 3295-3304
45.
Kerr J.S., Sherwood N., Hindmarch I. (1991) The comparative psychopharmacology of 5-HT re-uptake inhibitors. Hum Psychopharmacol6: 313-317
46.
Klein D.F. (1974) Endogenomorphic depression: a conceptual and terminological revision. Arch Gen Psychiatr31: 447-454
47.
Kragh-Sorensen P., Kristensen C.B., Pedersen O.L. et al. (1981) In Usdin E, Dahl S, Gram L F et al. (eds), Clinical pharmacology in psychiatry: neuroleptics and antidepressant research. Macmillan, London, pp. 351-358
48.
Lakshmanan M., Mion L.C., Frengley J.D. (1986) Effective low dose tricyclic antidepressant treatment for depressed geriatric rehabilitation patients: a double-blind study. J Am Geriatr Soc34: 421-426
49.
Lapierre Y.D. (1991) Controlling acute episodes of depression. Int Clin Psychopharmacol6 (Suppl 2): 23-35
50.
Laws D., Ashford J.J., Anstee J.A. (1990) A multicentre double-blind comparative trial of fluvoxamine versus lorazepam in mixed anxiety and depression treated in general practice. Acta Psychiatr Scand81: 185-189
51.
Leeper J., Badger L., Milo T. ( 1985) Mental disorders among physical disability determination patients. Am J Public Health75: 78-79
52.
Light R.W., Merrill E.J., Despars J., Gordon C.H., Mutalipassi L.R. (1986) Doxepin treatment of depressed patients with chronic obstructive pulmonary disease. Arch Intern Med146: 1377-1380
53.
Linn L.S., Yager J. (1982) Screening of depression in relationship to subsequent patient and physician behaviour. Med Care20: 1233-1240
54.
Lipsey J.R., Robinson R.G., Pearlman G.D. et al. (1984) Nortriptyline treatment of post-stroke depression: a double-blind study. Lanceti: 297-300
Lopez-Ibor J.J. (1991) The masking and unmasking of depression. In Feighner J P, Boyer W F (eds), The diagnosis of depression. Wiley, pp. 99-118
57.
Lundmark J., Scheel Thomsen I., Fjord-Larsen T. et al. (1989) Paroxetine: pharmacokinetic and antidepressant effect in the elderly. Acta Psychiatr Scand80 (Suppl. 350): 76-80
58.
Magni G., Schifano F., deLeo D. (1986) Assessment of depression in an elderly medical population. J Affective Disord11: 121-124
59.
Magni G. (1991) The use of antidepressants in the treatment of chronic pain. Drugs42: 730-748
60.
Mathew R.J., Weinman M.L., Mirabi M. (1981) Physical symptoms of depression. Br J Psychiatr139: 293-296
61.
Montgomery S.A. (1989) Fluoxetine in the treatment of anxiety, agitation and suicidal thoughts. In Stefanis C N, Soldatos C R, Rabavilas A D (eds), Psychiatry today: VIII world congress of psychiatry abstracts. Elsevier, New York, p. 335
62.
Murphy E. (1983) The prognosis of depression in old age. Br J Psychiatr142: 111-119
63.
Popkin M.K., Callies A.L., Mackenzie T.B. (1985) The outcome of antidepressant use in the medically ill. Arch Gen Psychiatr42: 1160-1163
64.
Preskorn S.H., Fast G.A. (1991) Therapeutic drug monitoring for antidepressants: efficacy, safety and cost effectiveness. J Clin Psychiatr52: 23-33
65.
Preskorn S.H. et al. (1992) Poster presented at the 145th Annual meeting of the APA, Washington, 2-7th May
66.
Preskorn S., Burke M. (1992) Somatic therapy for major depressive disorder: selection of an antidepressant. J Clin Psychiatr53 (Suppl 9): 5-18
67.
Price J., Waller P., Wood S. et al. (1992) Safety of fluoxetine: comparison with fluvoxamine . Pharmacoepidemiol Drug Safety1: 111-117
68.
Rapp S.R., Vrana S. (1989) Substituting non somatic for somatic symptoms in the diagnosis of depression in elderly male medical patients. Am J Psychiatr146: 1197-1200
69.
Ray W., Griffin M., Schaffner W. et al. (1987) Psychotropic drug use and the risk of hip fracture. N Engl J Med316: 363-369
70.
Rifkin A., Reardon G., Siris S. et al. (1985) Trimipramine in physical illness with depression . J Clin Psychiatr46: 4-8
71.
Rodin G., Craven J., Littlefield C. (1991) Depression in the medically ill. Brunner/Mazel , New York.
72.
Roose S.P., Glassman A.H., Giardina E.G. et al. (1987) Tricyclic antidepressants in depressed patients with cardiac conduction disease. Arch Gen Psychiatr44: 273-275
73.
Schulberg H., Saul M., McClelland M. et al. (1985) Assessing depression in primary medical and psychiatric practices. Arch Gen Psychiatr42: 1164-1170
74.
Schwartz J., Speed N., Clavier E. (1988) Antidepressant side effects in the medically ill: The value of psychiatric consultation. Int J Psychiatr Med18: 235-241
75.
Sindrup S.H., Brosen K., Gram L.F. (1992a) The relationship between paroxetine and sparteine oxidation polymorphism. Clin Pharmacol Ther51: 278-287
76.
Sindrup S.H., Brosen K., Gram L.F. (1992b) Pharmacokinetics of the selective serotonin re-uptake inhibitor paroxetine: Non linearity and relation to the sparteine oxidation polymorphism. Clin Pharmacol Ther51: 288-295
77.
Slome B.A. (1984) Rampant caries: a side effect of tricyclic antidepressant therapy. Gen Dent32: 494-496
78.
Stockley I. (1991) Tricyclic and related antidepressants+ fluoxetine . In Drug interactions. Blackwell Scientific Publications, Oxford, p. 595
79.
Stoudemire A., Frank R., Hedemark N. et al. (1986) The economic burden of depression. Gen Hosp Psychiatr8: 387-394
80.
Stoudemire A., Fogel B.S. (1987) Psychopharmacology in the medically ill. In Stoudemire A, Fogel B S (eds), Principles of medical psychiatry. Grune and Stratton, Orlando FL, pp. 79-112
81.
Stoudemire A., Moran M.G., Fogel B.S. et al. (1990) Psychotropic drug use in the medically ill . Psychosomatics31: 377-391
82.
Van Ameringen M., Mancini C. (1992) Adverse effects of switching from fluoxetine to desipramine. Can J Psychol37: 278
83.
Warrington S.J. (1991) Clinical implications of the pharmacology of sertraline . Int Clin Psychopharmacol6: 11-21
84.
Wells C.E., Duncan G.S. (1980) In Neurology for psychiatrists. FA Davis Co, Philadelphia, p. 215
85.
Whitlock F.A., Siskind M.M. (1980) Depression as a major symptom of multiple sclerosis . J Neurol Neurosurg Psychiatr43: 861-865