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El espectro amplio de la depresión comórbida: implicaciones para el tratamiento
Published online by Cambridge University Press: 12 May 2020
Resumen
Existe una alta tasa de depresión en los pacientes con trastornos médicos u otros trastornos psiquiátricos. Esta depresión comórbida se asocia con un aumento de la morbilidad y la mortalidad por enfermedad médica, un cumplimiento terapéutico malo, un empeoramiento de los síntomas somáticos y a menudo una disminución en el estado funcional. Varios estudios recientes han demostrado que la depresión comórbida es muy tratable y que el tratamiento efectivo a menudo aumenta el afrontamiento adaptativo de la enfermedad médica de los pacientes. Sin embargo, al escoger una terapia antidepresiva, se debe tener cuidado de hacer una valoración completa de la enfermedad del paciente y evitar potenciales interacciones entre fármacos y enfermedades relacionadas con fármacos. Esta revisión investiga el uso de los antidepresivos en pacientes deprimidos con trastornos médicos y psiquiátricos y su efecto sobre el pronóstico y la morbilidad, e indica que existe un lugar para el uso de las medicaciones antidepresivas en el tratamiento de las condiciones comórbidas. Por lo general, la mayor seguridad y tolerabilidad de los inhibidores selectivos de la recaptación de serotonina proporciona mejores opciones para el tratamiento de la depresión en el enfermo médico y psiquiátrico.
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- Copyright © European Psychiatric Association 1998
Footnotes
Mendlewicz J. The Broad spectrum of comorbid depression: implications for treatment. Eur Psychiatry 1998; 13: 1-8.
References
Bibliografía
Anderson, MTomenson, BM. The efficacy of selective serotonin re-uptake inhibitors in depression: a meta-analysis of studies against tricyclic antidepressants. J Psychopharmacol 1994; 8: 238-49.CrossRefGoogle ScholarPubMed
Anderson, MTomenson, BM. Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a metaanalysis. BMJ 1995; 310: 1433-8.Google Scholar
Baldwin, DRudge, S. The role of serotonin in depression and anxiety. Int Clin Psychopharmacol 1995; 9 Suppl 4: 41-5.CrossRefGoogle ScholarPubMed
Berken, GHWeinstein, DOStem, WC, Weight gain: a side-effect of tricyclic antidepressants. J Affective Disord 1984; 7: 133-8.CrossRefGoogle ScholarPubMed
Bowen, DJSpring, BFox, E, Tryptophan and highcarbohydrate diets as adjuncts to smoking cessation therapy. J. Behav Med 1991; 11: 17–34.Google Scholar
Boyer, W. Serotonin uptake inhibitors are superior to imipramine and alprazolam in alleviating panic attacks: a meta analysis. Int Clin Psychopharmacol 1995; 10: 45-9.CrossRefGoogle ScholarPubMed
Boyer, WFFeighner, JP. Side-effects of the selective serotonin re-uptake inhibitors. In: Perspectives in Psychiatry Volume 1, Selective Serotonin Re-uptake Inhibitors. Chichester: John Wiley; 1991, p. 133-52.Google Scholar
Boyer, WFMcFadden, GAFeigner, JP, The efficacy of selective serotonin re-uptake inhibitors in anxiety and obsessive-compulsive disorder. In: Feighner, JPBoyer, WF, eds. Perspectives in Psychiatry Volume 1, Selective Serotonin Re-uptake Inhibitors. Chichester: John Wiley; 1991 17–17.Google Scholar
Bryson, HMWilde, MI. Amitriptyline. A review of its pharmacological properties and therapeutic use in chronic pain States. Drugs Aging 1996; 8: 459-76.CrossRefGoogle ScholarPubMed
Caney, RRich, MWFreedland, K, Major depressive disorder predicts cardiac events in patients with coronary heart disease. Psychosom Med 1988; 50: 627-33.Google Scholar
Cassano, GBMusetti, LSoriani, ASavino, M, The pharmacologic treatment of depression: drug selection criteria. Pharmacopsychiatry 1993; 26: 17–23.Google ScholarPubMed
Clayton, PJ. The co-morbidity factor: establishing the primary diagnosis in patients with mixed symptoms of anxiety and depression. J Clin Psychiatry 1990; 51 Suppl: 35-9.Google ScholarPubMed
Coryell, WEndicott, J, Andreasen NC et al. Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Am J Psychiatry 1988; 145: 293–300.Google ScholarPubMed
Coulehan, JLSchulberg, HCBlock, MRJanosky, JEArena, VC, Medical co-morbidity of major depressive disorder in a primary medical practice. Arch IntemMed 1990; 150: 2363-7.CrossRefGoogle Scholar
Creed, FAsh, G. Depression in rheumatoid arthritis: aetiology and treatment. Int Rev Psychiatry 1992; 4: 23–34.CrossRefGoogle Scholar
Cummings, JL. Depression and Parkinson's disease: a review. J Clin Psychiatry 1992; 149: 443-54.Google ScholarPubMed
Cunningham, LA. Depression in the medically ill: choosing an antidepressant. J Clin Psychiatry 1994; 55 Suppl A: 90-7.Google ScholarPubMed
Dalack, GWRoose, SP. Perspectives on the relationship between cardiovascular disease and affective disorder. J Clin Psychiatry 1990; 51 Suppl: 4–9.Google ScholarPubMed
Davis, RWhittington, R, Bryson F1M. Nefazodone. A review of its pharmacology and clinical efficacy in the management of major depression. Drugs 1997; 53: 608-36.CrossRefGoogle ScholarPubMed
Dunbar, GCCohn, JB, Fabre LF et al. A comparison of paroxetine, imipramine, and placebo in depressed out-patients. Br J Psychiatry 1991; 159: 394-8.Google ScholarPubMed
Eison, MS. Serotonin: a common neurobiologic substrate in anxiety and depression. J Clin Psychopharmacol 1990; 10 Suppl: 26–30.CrossRefGoogle ScholarPubMed
Fawcett, J. Targeting treatment in patients with mixed symptoms of anxiety and depression. J Clin Psychiatry 1990; 51 Suppl: 40-3.Google ScholarPubMed
Feighner, JP,Boyer WF, Meredith CH, Hendrickson GG. A double-blind comparison of fluoxetine, imipramine, and placebo in outpatients with major depression. Int Clin Psychopharmacol 1989; 4: 127-34.Google ScholarPubMed
Feighner, JPCohn, JBFabre, LF et al. A study comparing paroxetine, placebo and imipramine in depressed patients. J Affective Disord 1993; 28: 719.CrossRefGoogle ScholarPubMed
Feighner, JP. Cardiovascular safety in depressed patients: focus on venlafaxine. J Clin Psychiatry 1995; 56: 574-9.Google ScholarPubMed
Feldman, EMayou, RHawton, KSmith, EB, Psychiatry disorder in medical inpatients. Q J Med 1987; 63: 405-12.Google Scholar
Fernandez, F. Depression and its treatment in cardiac patients. Texas Heart Institute J 1993; 20: 188-97.Google ScholarPubMed
Femstrom, MHKowinski, RLKupfer, DJ, Appetite and food preference in depression: effects of imiprimine treatment. Biol Psychiatry 1987; 22: 529-39.CrossRefGoogle Scholar
Fielding, R. Depression and acute myocardial infarction: A review and reinterpretation. Soc Sci Med 1991; 32: 1017-27.CrossRefGoogle ScholarPubMed
Finkelstein, SPWeintraub, RJKarmouz, N, Antidepressant drug treatment for post-stroke depression: retrospective study. Arch Phys Med Rehabil 1987; 68: 772-6.Google Scholar
Fisch, C. Effect of fluoxetine on the electrocardiogram. J Clin Psychiatry 1985; 46: 42-4.Google ScholarPubMed
Frank, RGKashani, JH, Parker JC et al. Antidepressant analgesia in rheumatoid arthritis. J Rheumatol 1988; 15: 1632-8.Google ScholarPubMed
Frasure-Smith, NLesperance, FTalajic, M, Depression following myocardial infarction: impact on 6-month survival. JAMA 1993; 270: 1819-25.CrossRefGoogle ScholarPubMed
Glassman, AHPreud’Homme, XA. Review of the cardiovascular effects of heterocyclic antidepresants. J Clin Psychiatry 1993; 54 Suppl 2: 16–22.Google Scholar
Glassman, AHRoose, SP, Bigger, JT Jr. The safety of tricyclic antidepressants in cardiac patients. Riskbenefit considered. JAMA 1993; 269: 2673-5.CrossRefGoogle Scholar
Gonzalez Torrecillas, JIMendlewicz, JLobo, A, Effects of early treatment of poststroke depression on neuropsychological rehabilitation. In Psychogeriatr 1995; 7: 547-60.CrossRefGoogle ScholarPubMed
Gonzalez Torrecillas, JIMendlewicz, JLobo, A, Analysis of intensity of post-stroke depression and its relationship with the cerebral lesion location. Med Clin (Bare) 1997; 109: 241-4.Google ScholarPubMed
Goodnick, PJHenry, JHBuki, VM, Treatment of depression in patients with diabetes mellitus. J Clin Psychiatry 1995; 56: 128-36.Google ScholarPubMed
Goodnick, PJKumar, AHenry, JHBuki, VMGoldberg, RB, Sertraline in coexisting major depression and diabetes mellitus. Psychopharmacol Bull 1997; 33(2): 261-4.Google ScholarPubMed
Goldberg, DPLecrubier, Y. Form and frequency of mental disorders access centers. In; Ustun, TBSartorius, N.Mental illness in general health care. United Kingdom: Wiley; 1995; p 323-34.Google Scholar
Greenberg, MSStiglin, LEFinkelstein, SNBerndt, ER, Depression: a neglected major illness. J Clin Psychiatry 1993; 54: 419-24.Google ScholarPubMed
Grunhaus, L. Clinical and psychobiological characteristics of simultaneous panic disorder and major depression. Am J Psychiatry 1988; 154: 1214-21.Google Scholar
Henderson, RKurlan, RKersun, JMComo, P, Preliminary examination of the co-morbidity of anxiety and depression in Parkinson's disease. J. Neuropsychiatry Clin Neurosci 1992; 4: 257-64.Google ScholarPubMed
Hunter, B. Depression associated with rheumatoid arthritis - comparison of paroxetine and amitriptyline. Poster presented at lOth European College of Neuropsychopharmacology Congress, Vienna, Austria, September 1997.Google Scholar
Ibbotson, TMaguire, PSelby, PPriestman, TWallace, L, Screening for anxiety and depression in cancer patients: the effects of disease and treatment. Eur J Cancer 1994; 30: 37–40.CrossRefGoogle Scholar
Judge, RSteiner, M. The long-term efficacy and safety of paroxetine in panic disorder. Eur Neuropsychopharmacol 1996; 6 suppl 3: 207.Google Scholar
Kasper, SZivkov, MRoes, KCPols, AG, Pharmacological treatment of severely depressed patients: a meta-analysis comparing efficacy of mirtazapine and amitriptyline. Eur Neuropsychopharmacol 1997; 7: 115-24.CrossRefGoogle ScholarPubMed
Katon, WSullivan, MD. Depression and chronic medical illness. J Clin Psychiatry 1990; 51 Suppl 6: 3–11.Google ScholarPubMed
Katz, PPYelin, EH. Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis. J Rheumatol 1993; 20: 790-6.Google ScholarPubMed
Keller, MBHanks, DL. Anxiety symptom relief in depression treatment outcomes. J Clin Psychiatry 1995; 56 Suppl 6: 22-9.Google ScholarPubMed
Kessler, RCMcGonagle, KAZhao, S et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51(1): 8–19.Google ScholarPubMed
Kessler, RCNelson, CBMcGonagle, KALiu, J et al. Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. Br J Psychiatry 1996; 30 suppl: 17–30.CrossRefGoogle Scholar
Le Cavorzin, PHSarkis, SBeneton, C et al. FIuvoxamine et syndrome serotoninerique chez un malade pakinsonien. Therapie 1996; 51: 191-6.Google Scholar
Lecrubier, YBourin, MMoon, CAL, Schifano F et al. Efficacy of venlafaxine in depressive illness in general practice. Acta Psychiatr Scand 1997; 95: 485-93.CrossRefGoogle ScholarPubMed
Lydiard, RB. Co-morbidity of panic disorder, phobia and major depression. Eur Psychiatry 1995; 10 Suppl 2: 65s-6s.CrossRefGoogle ScholarPubMed
Lund, JThayssen, PMengel, HPedersen, OLKristensen, CDGram, LF, Paroxetine: pharmacokinetics and cardiovascular effects after oral and intravenous single doses in man. Acta Pharmacol Toxicol (Copenhagen) 1982; 51: 351-7.CrossRefGoogle ScholarPubMed
McDaniel, JSMusselman, DLPorter, MRReed, DANemeroff, CB, Depression in patients with cancer. Diagnosis, biology and treatment. Arch Gen Psychiatry 1995; 52: 89–99.CrossRefGoogle ScholarPubMed
Massie, MJHolland, JC. Depression and the cancer patient. J Clin Psychiatry 1990; 51 Suppl: 12-7.Google ScholarPubMed
Mancini, CAmerigen, MV. Paroxetine in social phobia. J Clin Psychiatry 1996; 57: 519-22.CrossRefGoogle ScholarPubMed
Mayeux, RStern, YCote, LWilliams, JB, Altered serotonin metabolism in depressed patients with Parkinson’s disease. Neurology 1984; 34: 642-6.CrossRefGoogle ScholarPubMed
Mayeux, RStern, YWilliams, JBCote, LFrantz, ADrenforth, I, Clinical and biochemical features of depression in Parkinson's disease. Am J Psychiatry 1986; 143: 756-9.Google ScholarPubMed
Meredith, LWells, KCamp, P, Clinician speciality and treatment style for depressed outpatients with and without medical comorbidities. Arch Fam Med 1994; 3: 1065-72.CrossRefGoogle Scholar
Montgomery, SA. SSRIs: Well tolerated treatment for depression. Hum Psychopharmacol 1994; 9(SI): 7–10.CrossRefGoogle Scholar
Montgomery, SAProst, JFSolles, ABriley, M, Efficacy and tolerability of milnacipran: an overview. lnt Clin Psychopharmacol 1996; 11 suppl 4: 47–51.CrossRefGoogle ScholarPubMed
Morganroth, JGoin, JE. Quinidine-related mortality in the short-to-medium-term treatment of ventricular arrhythmias: a meta-analysis. Circulation 1991; 84: 1977-83.CrossRefGoogle ScholarPubMed
Murphy, JMOlivier, DCSobol, AMMonson, RRLeighton, AH, Diagnosis and outcome: depression and anxiety in a general population. Psychol Med 1996; 16: 117-26.CrossRefGoogle Scholar
Nelson, JC. Safety and tolerabiliy of the new antidepressants. J Clin Psychiatry 1997; 58 suppl 6: 26–31.Google Scholar
Parker, JCWright, GE. The implications of depression for pain and disability in rheumatoid arthritis. Arch Care Res 1995; 8: 279-83.CrossRefGoogle ScholarPubMed
Puech, AMontgomery, SAProst, JFSolles, ABriley, M, Milnacipran, a new serotonin and noradrenaline reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability. hit Clin Psychopharmacol 1997; 12: 99–108.CrossRefGoogle ScholarPubMed
Rechlin, T. The effect of amitriptyline, doxepin, fluvoxamine, and paroxetine treatment on heart rate variability. J Clin Psychopharmacol 1994; 14: 392-5.CrossRefGoogle ScholarPubMed
Reding, MJOrto, LAWinter, SWFortuna, IMDiPonte, PMcDowell, FH, Anti-depressant therapy after stroke, a doubleblind trial. Arch Neurol 1986; 43: 763-5.CrossRefGoogle Scholar
Richard, IHKurlan, R. A Survey of antidepressant drug use in Parkinson's disease. Parkinson Study Group. Neurology 1997; 49: 1168-70.CrossRefGoogle ScholarPubMed
Robinson, DSRoberts, DLSmith, JMStringfellow, JC et al. The safety profile of nefazodone. J Clin Psychiatry 1996; 57 suppl 2: 31-8.Google ScholarPubMed
Roose, SPDalack, GW. Treating the depressed patient with cardiovascular problems. J Clin Psychiatry 1992; 53: 25–31.Google ScholarPubMed
Schleifer, SJMacari-Hinson, MM, Coyle DA et al. The nature and cour.se of depression following myocardial infarction. Arch Intem Med 1989; 149: 1785-9.CrossRefGoogle Scholar
Schleifer, SJMacari-Hinson, MM, Coyle DA et al. The nature and course of depression following myocardial infarction. Arch Intem Med 1989; 141: 1785-9.CrossRefGoogle Scholar
Schneier, FRJohnson, JHornig, CDLiebowitz, MRWeissman, MM, Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry 1992; 49: 282-8.CrossRefGoogle Scholar
Sommi, RWCrismon, MLBowden, CI, Fluoxetine: a serotonin specific, second generation antidepressant. Pharmacotherapy 1987; 7: 1–15.CrossRefGoogle ScholarPubMed
Stimmel, GLDopheide, JAStahl, SM, Mirtazapine: an antidepressant with noradrenergic and specific serotonergic effeets. Pharmacotherapy 1997; 17: 10–21.Google Scholar
Suchowersky, O, de Vries JD. Interaction of fluoxetine and selegiline [letter]. Can J Psychiatry 1990; 53: 571-2.CrossRefGoogle Scholar
Teri, LWagner, A. Alzheimer's disease and depression. J Consult Clin Psychiatry 1992; 60: 379-91.CrossRefGoogle ScholarPubMed
The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. New Engl J Med 1989; 321: 406-12.CrossRefGoogle Scholar
The Cardiac Arrhythmia Suppression Trial II Investigators. Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. New Engl J Med 1992; 327: 227-33.Google Scholar
Tiller, JWG. Post-stroke depression. Psychopharmacology 1992; 106: SI30-33.CrossRefGoogle ScholarPubMed
Toyama, SCIacono, RP. Is it safe to combine a selective serotonin reuptake inhibitor with selegiline? Aunais of Pharmacotherapy 1994; 28: 405-6.Google Scholar
Van Loon, BJPRadder, JKFrohlich, MKrans, HMZwinderman, AHMeindes, AE, Fluoxetine increases insulin action in obese nondiabetic and in obese noninsulin dependent diabetic individuais. Int J Obesity 1992; 16: 79–85.Google Scholar
Verrier, RL. Neurochemical approaches to the prevention of ventricular fibrillation. Fed Proc 1986; 45: 2191-6.Google ScholarPubMed
Wallen, JPincus, HAGoldman, HH, Psychiatric consultations in short-term general hospitals. Arch Gen Psychiatry 1987; 44: 163-88.Google ScholarPubMed
Weiss, DM. Serotonin syndrome in Parkinson disease. J Am Board Family Practice 1995; 8: 400-2.Google ScholarPubMed
Wells, KBStewart, A, Hays RD et al. The functioning and wellbeing of depressed patients. JAMA 1989; 262: 914-9.CrossRefGoogle Scholar
Wells, KBBurnham, MARogers, WHays, RCamp, P, The course of depression in adult outpatients. Results from the Medical Outcomes Study. Arch Gen Psychiatry 1992; 49: 788-94.Google Scholar
Wells, KBRogers, WBurnam, MACamp, P, Course of depression in patients with hypertension, myocardial infarction, or insulin-dependent diabetes. Am J Psychiatry 1993; 150: 632-8.Google ScholarPubMed
Williams, RBChesney, MA. Psychosocial factors and prognosis in established coronary artery disease: the need for research on interventions. JAMA 1993; 270: 1860-1.CrossRefGoogle ScholarPubMed
Wolkow, RApter, JClayton, A et al. Double-blind flexible dose study of sertraline and placebo in patients with panic disorder. Presented at the 20th CINP, Melbourne, Australia, June 1996.Google Scholar
Zohar, J, Judge R and the OCD Paroxetine Study Investigators. Paroxetine versus clomipramine in the treatment of obsessive-compulsive disorder. Br J Psychiatry 1996; 169: 468-74.CrossRefGoogle ScholarPubMed