nisha
lil monkey
Topics: 146
Posts: 919
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You have been treating a 42-year-old woman for her first episode of depression over the past 3
months. You placed her on fluoxetine and she began to show an adequate response at 8 weeks. She
has been very satisfied with the results because she now has a lot more energy, feels happier, and is
able to concentrate. She was divorced 3 years earlier and has recently begun dating a "great" man and
they have been talking about marriage. She denies any suicidal ideation and does not have any
psychotic symptoms. She wants to know if she can discontinue the medication. The most appropriate
response is:
A. "Because the new relationship is making you happy, it is probably unnecessary to continue
the medication"
B. "Even though you are feeling better, the medication should be continued for at
least 6-9 months"
C. "If you stop taking the medication right now you will have a relapse of your depression"
D. "Since you are feeling better, you should taper the medication over a week and then
discontinue it"
E. "You can stop taking the medication today because you seem to be feeling much better"
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| catmd
Forum Senior
Topics: 7
Posts: 129
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B - to avoid a relapse?
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| drkpp
Forum Guru
Topics: 45
Posts: 882
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i think for first episode it was only for 3 months???????????
i wld go with E. or maybe taper it but its no corticosteroids.......
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"Where there is a will there is a way!"
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| catmd
Forum Senior
Topics: 7
Posts: 129
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You could be right but one needs to taper SSRI's to avoid w/drawal phen - agitation, dysphoria, flu-like state.
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| nisha
lil monkey
Topics: 146
Posts: 919
|
The correct answer is B. It is usually recommended that a patient remain on antidepressant
medication for at least 6-9 months after a remission is reached to help to prevent a relapse. The
medications typically take about 2 months to reach an adequate response and should be continued
even after this response is reached. Indefinite therapy should be considered for patients who have
had 2 or more episodes of depression. Even though this new relationship is making her happy, she should not discontinue the medication
(choice A). As stated above, the medication should be taken for at least 6-9 months to help to
prevent relapse. Even though she may have a relapse if she stops taking the medication now (choice C) it is best to
try to explain to her that it should be continued for at least 6-9 months, without scaring her or
threatening her. Also, gyou may have a relapseh, is more appropriate than, "you will
have a relapse". As stated above, she should stay on the medication even after remission is achieved and therefore it
is incorrect to tell her that she should taper the medication over a week and then discontinue it
(choice D) or to stop taking it today (choice E). When the time comes to discontinue it, it is best to
taper it as opposed to just abruptly stopping it so that the body can adjust better to the withdrawal of
the medication.
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| drkpp
Forum Guru
Topics: 45
Posts: 882
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ok. i think 3 months was for rx after first episode of mania???????????????
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"Where there is a will there is a way!"
-Anonymous
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