Year: 2016
Type: article
Study design: Case Report
Abstract: Targeting dopamine is critical in the management of treatment-resistant depression (TRD).This case report highlights the potential role of the combination of dextroamphetamine and pramipexole in the management of treatment-resistant unipolar depression.Using dopaminergic medications in the management of TRD may lead to better outcomes. CASE REPORTThe patient was a 40-year-old man with TRD stage III 1 who had good response to four sessions of electroconvulsive therapy in the past.The following medications had not worked for him: fluoxetine, sertraline, escitalopram 30 mg, citalopram, venlafaxine, mirtazapine 45 mg, bupropion 300 mg, buspirone 60 mg, and methylphenidate 10 mg (the patient noted that taking methylphenidate 10 mg felt like "being in a roller coaster").The dose of several medications and the duration and details on whether the patient was on any combination of antidepressants was not available in his medical history.His Patient Health Questionnaire-9 score decreased from 25 to 10 in over a period of 35 weeks.His functioning improved in the following areas: he was able to go out socially with people, get out of the house more often, enjoyed riding his motorcycle, read books, listened to music, and drove on a long distance trip with his friend.The patient was monitored on a regular basis via phone calls in between regularly scheduled follow-up appointments.Medication titrations were conducted during the phone calls.Interventions from each follow-up visit are shown on Table 1. DISCUSSIONWhen clinicians manage treatment-resistant patients, it is important to do a detailed psychotropic history.Otherwise, they are likely to prescribe medications from the same class
Source: Psychiatric Annals
Authors: Maju Mathew Koola, Jan Fawcett
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2505757798