Depression and use of antidepressants in the critical patient

• Published in: Medicina intensiva Vol. 32 Spec No. 1; pp. 92 - 99
• Main Authors: Sandiumenge, A, Torrado, H
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.02.2008
• Subjects: Antidepressive Agents - classification; Antidepressive Agents - therapeutic use; Critical Illness - psychology; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - etiology; Diagnostic and Statistical Manual of Mental Disorders; Humans; Intensive Care Units
• ISSN: 0210-5691

A large percentage of critically ill patients suffer from depression while admitted in an Intensive Care Unit (ICU). This pathology, often underdiagnosed by intensive care professionals has a proved negative impact on median-large outcome, which makes early detection and management a key issue. However diagnosing depression in ICU is a complicated task since there are no validated tools for its detection. The cornerstone intervention for the treatment of depression are antidepressant medication. All antidepressants have similar efficacy profiles. The prescription of a particular agent should be done based in its collateral effects. Unfortunately the efficacy and safety of antidepressant agents has not been evaluated in the critically ill patient. The implementation of simple measures like guaranteeing comfort during its admission to the ICU and the early reintroduction of any psychotropic medication that the patient could be taking before ICU could improve the emotional adaptation to their new situation.