Table 1

Messages delivered during detailing session
Phase I Treatment-resistant Depression in the Primary Care Setting
· Formulate a treatment plan at the start of therapy
· Prior to switching or augmenting an antidepressant consider a longer trial (12–14 weeks) at a therapeutic dose
· Triiodothyronine (T3, cytomel) is an effective and well tolerated augmentation agent
Use of Atypical Antipsychotics in Treatment –resistant Depression
· Consider T3 (or lithium) prior to considering atypical antipsychotic augmentation agent
· Atypical antipsychotics are associated with metabolic abnormalities and require regular monitoring
Phase II Pharmacotherapy options for Insomnia
· Cognitive behavior therapy and pharmacologic treatment approaches have similar effectiveness
· All sedative/hypnotics appear to be comparable in treating insomnia
· Clinical data regarding sedating antidepressants and antipsychotics are lacking
Clinical use and comparative effectiveness of benzodiazepines
· Long-term benzodiazepine use is rarely warranted
· Withdrawal of benzodiazepine has led to improvements in cognitive functioning, balance, and memory without worsening insomnia (particularly in frail elderly)
· Discontinuation should always include gradual tapering

Hartung et al.

Hartung et al. BMC Family Practice 2012 13:129   doi:10.1186/1471-2296-13-129

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