The American Psychiatric Association Identifies The Use Of Pharmacological Treatments

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The American Psychiatric Association identifies the use of pharmacological treatments in all four of the phases of treatment for MDD. In particular, during the acute phase, the authors of the APA guidelines recommended the use of pharmacological treatments, initially beginning with first-line antidepressant treatments. This includes Selective Serotonin Reuptake Inhibitor (SSRI) or Serotonin-Norepinephrine Reuptake Inhibitors (SNRI), such as Remeron and/or Wellbutrin (Armstrong, 2011; APA, 2010). The APA also recommended over-the-counter (OTC) remedies, including St. John’s Wort and 5-HTP. Noteworthy, the APA has cautioned against the use of OTC’s in general, as these medications need to be monitored closely, and they have not been approved by the Federal Drug Administration (FDA). There are multiple types of treatment interventions for MDD offered in community mental health agencies, but not all. A newer medical treatment intervention, not currently funded for Medicaid clients, includes Transcranial Magnetic Stimulation (TMS, 2008). Much like Electroconvulsive therapy, the FDA has approved TMS, as a treatment for individuals with MDD which have previously failed to respond to a first-line antidepressant (Wier, 2015). Many benefits have been discovered with the use of TMS treatments, particularly when compared to ECT treatments and/or sham treatments (Wier, 2015). In a study that evaluated the benefits of TMS, ECT and sham treatments, TMS clients reported that TMS treatment felt less traumatic to their body than ECT. Individuals reported that it was less traumatic than ECT, as they received treatments while awake (Wier, 2015). Also noted, were that clients experienced less time in recovery after TMS procedures than other interven... ... middle of paper ... ...was a clinically useful predictor of eventual remission as well as the level of improvement at that time point that optimally predicts remission” (Steidtmann et. al, 2013, p. 785). Steidtmann et al. (2013) determined that individuals with chronic depression “…who will not remit in structured, time-limited psychotherapy for depression, either with therapy alone or in combination with antidepressant medication, are identifiable prior to end of treatment” (p. 783). The researchers concluded that these findings may provide an operationalized strategy for designing adaptive psychotherapy interventions. Köhler et al.’s, (2013) research led to further assessment of remission rates for MDD. They found in their study that remission rates were significantly higher in the combined treatment group (consisting of medication and CBT treatment) than in the primary care only group.

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