Page 348 - Learnwell EVS
P. 348
11. Mental/psychical disorders in adults
If m a jor s ym p tom s ha v e not r e s olv e d a t a ll a fte r a m onth a t a nor m a lly-
reefffeecr ttivhee pdaotsieen,t to a p s yc hia tr is t, if p os s ible ; if not, tr y a d iffe r e nt a ntid e p r e s s a nt .
2
T he tr e a tm e nt s hould a lw a ys be s top p e d gr a d ua lly (ov e r a 2 -w e e k p e r iod for
SR Is , a nd
a 4 - w e e k p e r iod for tr ic yc lic s ) . I n for m th e p a tie n t a bout p r oble m s
a s s oc ia t e d w ith
a br up t tr e a tm e nt d is c ontinua tion (v e r y c om m on w ith p a r oxe tine ).
11
In case of treatment failure with an SRI: if the patient is under paroxetine, reduce the dose over a two-week
2
period to avoid withdrawal symptoms, then wait 2 to 4 days before starting the tricyclic antidepressant. If the
patient is under fluoxetine, stop fluoxetine (withdrawal symptoms are unlikely) and wait at least 10 to 14 days
before starting the tricyclic antidepressant.
If m a jor s ym p tom s ha v e not r e s olv e d a t a ll a fte r a m onth a t a nor m a lly-
reefffeecr ttivhee pdaotsieen,t to a p s yc hia tr is t, if p os s ible ; if not, tr y a d iffe r e nt a ntid e p r e s s a nt .
2
T he tr e a tm e nt s hould a lw a ys be s top p e d gr a d ua lly (ov e r a 2 -w e e k p e r iod for
SR Is , a nd
a 4 - w e e k p e r iod for tr ic yc lic s ) . I n for m th e p a tie n t a bout p r oble m s
a s s oc ia t e d w ith
a br up t tr e a tm e nt d is c ontinua tion (v e r y c om m on w ith p a r oxe tine ).
11
In case of treatment failure with an SRI: if the patient is under paroxetine, reduce the dose over a two-week
2
period to avoid withdrawal symptoms, then wait 2 to 4 days before starting the tricyclic antidepressant. If the
patient is under fluoxetine, stop fluoxetine (withdrawal symptoms are unlikely) and wait at least 10 to 14 days
before starting the tricyclic antidepressant.
