SNRIs
Explore treatment options for Generalized Anxiety Disorder
As a clinical pharmacist, it's essential to recognize that about 1 in 13 adults in the US will be diagnosed with generalized anxiety disorder in their lifetime. Recommend cognitive behavioral therapy or meds as the initial treatment for generalized anxiety disorder, efficacy seems similar. Be ready to use a stepwise approach if meds are preferred... …
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SNRIs
Cymbalta for lower back pain
Cymbalta (duloxetine) will be used more for chronic musculoskeletal pain in the lower back or due to osteoarthritis . Cymbalta is already approved for neuropathic pain . Plus, it's approved for chronic musculoskeletal pain, so physicians are hearing more about this use, too. Some antidepressants do have analgesic effects, especially tricyclics (amitriptyline, …
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SSRIs
Make sense when combining antidepressants
As a clinical pharmacist, you should individualize the choice of antidepressant combos. So the question is, does it make sense to combine antidepressants? Yes, sometimes. Fewer than half of patients with depression achieve remission with one first-line medication (SSRI, SNRI, etc). Adding a different medication class may wor…
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SNRIs
Compare medications for DIABETIC Neuropathy
Up to 50% of patients with diabetes develop peripheral neuropathy. Tailor medication selection based on side effects, cost, whether the medication can also treat other conditions, etc. Expect trial and error... Start at low doses and titrate to effect. But set realistic expectations. In general, fewer than 1 in 3 patients will see a 50% decrease in pain with first-l…
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SNRIs
Medications and supplements induced hypertension
Patients are often surprised when they learn they're taking medications that can INCREASE blood pressure or induced hypertension (HTN) . Check for common culprits if patients have new or worsening high blood pressure. Explain that most patients won't have a significant blood pressure increase with these medications, but some could see a 5 to 10 mmHg bump in s…
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SSRIs
Depression and cardiovascular disease
Introduction ― Depression is common in patients with cardiovascular (CV) disease. Symptoms of depression are seen in 65% of patients after an acute myocardial infarction (MI). Major depressive disorder is diagnosed in up to 20% of patients after an acute coronary syndrome. Depression is associated with a doubling in the risk of a cardiovascular event within one to t…
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SSRIs
Address depression in patients after a heart attack
How to treat depression after a heart attack? this is important questions. Depression occurs in nearly half of heart attack patients and it's associated with a higher risk of CV events and death. Plus adherence to lifestyle changes and cardiovascular medications, antiplatelets, statins, etc may be even harder for patients with depression. But don't recommend …
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