Citation

Ameis S, Feinstein A. Therapy 2007; 4(3): 339-347.

Copyright

(Copyright © 2007)

DOI

10.2217/14750708.4.3.339

PMID

unavailable

Abstract

Approximately one in two multiple sclerosis patients will develop a major depression over the course of their lifetime. This is associated with a decreased quality of life and a high risk of completed suicide. A literature review suggests pharmacotherapy with a selective serotonin-reuptake inhibitor or tricyclic antidepressant is effective, the former likely better tolerated. Limited data show that psychotherapy, namely cognitive-behavioral and insight-oriented therapies, is effective, although cognitive-behavioral therapy is the only modality shown to rival medication in bringing about symptom response. Electroconvulsive therapy should be reserved for severe cases of depression as it may increase the risk of multiple sclerosis exacerbation. In treating the depressed multiple sclerosis patient, clinicians should always be on the lookout for comorbid anxiety. © 2007 Future Medicine Ltd.

Language: en

Keywords

human; Depression; suicide; quality of life; insomnia; depression; prevalence; Multiple sclerosis; clinical trial; risk assessment; disease severity; Pharmacotherapy; review; anorexia; vomiting; personality disorder; sexual dysfunction; doxepin; drug metabolism; amfebutamone; amitriptyline; citalopram; desipramine; fluoxetine; fluvoxamine; imipramine; mirtazapine; moclobemide; nortriptyline; paroxetine; sedation; serotonin uptake inhibitor; sertraline; tricyclic antidepressant agent; venlafaxine; xerostomia; headache; behavior therapy; cognitive therapy; disease course; appetite disorder; medical decision making; urine retention; constipation; electroconvulsive therapy; gastrointestinal symptom; orthostatic hypotension; tranylcypromine; psychopharmacotherapy; placebo; drug blood level; seizure; drug cost; drug efficacy; diarrhea; drug tolerability; nausea; tremor; drug withdrawal; hypotension; disease exacerbation; hypertension; side effect; fluvoxamine maleate; cost benefit analysis; agitation; heart arrhythmia; body weight; phenelzine; Beck Depression Inventory; heart palpitation; multiple sclerosis; nervousness; dyspepsia; dizziness; unspecified side effect; drug induced headache; drug dose increase; clinical effectiveness; blurred vision; isocarboxazid; interferon beta serine; hypertensive crisis; multiple cycle treatment; Selective serotonin-reuptake inhibitor; serotonin 1 receptor