- Education to Patient
- When counseling patients with depression who are receiving antidepressant medications, the patient should be informed that adverse effects might occur immediately, while resolution of symptoms may take 2 to 4 weeks or longer. Adherence to the treatment plan is essential for a successful outcome, and tools to help increase medication adherence should be discussed with each patient.
- Do not discontinue without talking to provider first
- Need of routine use
- Avoid alcohol/CNS depressants
- Risk of suicidality
- Report any worsening of depression and/or suicide ideation to provider
- Interview Questions:
- What are your symptoms? Have you had these symptoms before?
- How long have you felt this way?
- Have you had any problems concentrating or problems remembering?
- Have you thought about death or suicide?
- What social support do you have?
- Would you be willing to do/try CBT (therapy)?
Serotonin syndrome: mental status changes, autonomic instability, gastrointestinal symptoms, neuromuscular changes, seizures. Occurs when multiple serotonergic medications are used together