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Major Depression: Symptoms and Treatment

The Introduction: the major symptoms of a mental disorder

I would like to provide you with some necessary information, which is related to one of the most dangerous mental disorders. I want you to become familiar with the so-called major depressive disorder. Some years ago, I experienced depression, so, I want to tell you about my feelings, the treatment protocol and the ways I used to overcome the difficulties.

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Major depression is mostly known as a clinical depression, which is characterized by a number of symptoms. The most important signs of a mental disorder are low mood and the absence of desire to enjoy various activities. In other words, a person with a major depression feels regret or guilt all the time; there is no desire to experience pleasure when doing something; on the contrary, a person is not interested in various activities and keeps silence for the most part. The secondary signs are considered to be a loss of energy, feelings of worthlessness, indecisiveness, insomnia, thoughts of death and significant weight loss. There are biological, psychological, social, and evolutionary causes of major depression. Alcohol use is also recognized to be the reason of a mental disorder. As for me, the reasons of my disorder were mostly psychological. The subtype of the disorder I suffered was melancholic depression. The above-mentioned symptoms except alcohol use are related to the type. I would like to point out that other types of a clinical disorder are atypical depression, catatonic depression, postpartum depression, and seasonal affective disorder.

The thesis statement

Major depression requires careful treatment. The stage of a mental disorder determines the treatment protocol. There are the symptoms of depression, which a doctor is to consider in order to prescribe a medication. There is a need to rely on an integrated approach to provide a patient with an appropriate treatment.

The body: the most appropriate ways to treat a disease

When my diagnosis was defined, I started to think about the treatment and its cost. I decided to receive a treatment for MDD in Canada. In other words, I needed a different scene. Thus, the typical cure included antidepressants treatment. The major drugs were selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors. On the other hand, there was also a need to apply cognitive behavioral therapy to impact on my emotional state.

Generally, the first type of antidepressants was the most appropriate medicine for me. However, I searched the Internet with some medical sources and found an article of the psychiatrist Harry Croft. He states that “the high cost of the SSRIs can be a real hardship for someone with no insurance, or whose insurance doesn’t cover drugs” (1). Moreover, selective serotonin reuptake inhibitors caused liver diseases and their dose couldn’t be varied. The last reason was probably the most important one. I couldn’t choose tricyclic antidepressants as they had numerous side effects, and I didn’t want to pay twice for another disease the medicine could cause. Monoamine oxidase inhibitors required a strict diet, which I couldn’t be on as it was one of the secondary reasons of my disorder. The last option was serotonin and norepinephrine reuptake inhibitors. Thus, as far as I suffered from melancholic depression, I needed more serotonin and norepinephrine in my brain, so the antidepressant was right for me. I took SNRIs for six months. It cost $4,156. For venlafaxine-XR (serotonin and norepinephrine reuptake inhibitors) symptom free days were 54. For the drug the cost-effectiveness was $77.86 per symptom free days.

SNRIs: Venlafaxine. Cost and Costs Sources

Cost item Cost ($) Source
DrugCost
Venlafaxine XR 150 mg $ 1.65 ODB
Venlafaxine XR 75 mg $ 1.56 ODB

ODB – Ontario Drug Benefit Formulary

Sadri Hamid states, “Despite a higher drug acquisition cost, venlafaxine XR may be cost -effective and even cost saving compared to generic SSRIs in first line treatment of MDD in Canadian practice” (1).

The cost of CBT varies. My cognitive behavioral therapy cost 100 US dollars per hour. Antonuccio confirms that “CBT sessions are costed at $100 per individual session “(p. 194). I needed the therapy once in a week during a year. Thus, 5, 200 US dollars I spent on additional course of treatment. Generally, I spent $ 9, 400.

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The conclusion: economically efficient treatment

The long run treatment is more economically efficient than the short run medication. First of all, short run treatment is not effective, as there is no time to delve deeply into the details of major depression. Short run treatment means ineffective medication; so, there is a great probability that a patient will return to a psychiatrist again. Thereby, a patient is to pay twice for his/her treatment.

Works Cited

Antonuccio, David. A Cost-Effectiveness Analysis of Cognitive-Behavior Therapy and Fluoxetine (Prozac) in the Treatment of Depression, 1997. Web.

Croft, Harry. Selective Serotonin Reuptake Inhibitors, 2005. Web.

Keller, Martin. Issues in treatment-resistant depression, 2006. Web.

Sadri, Hamid., Han, Donald., Nourse, Allison., McIntyre, Roger. Cost-Effectiveness of Venlafaxine Extended Release in Major Depressive Disorder: A Canadian Perspective, 2011. Web.

Appendix 1

Dosages and Costs of Selected Antidepressants

Medication Typical dosage range per day Cost* Lower dose in renal/liver diseases
Selected SSRIs
Citalopram (Celexa) 20 to 60 mg $9 to 78† (20 mg, #30) No/yes
Escitalopram (Lexapro) 10 to 20 mg 81 (10 mg, #30) No/yes
Fluoxetine (Prozac) 20 to 80 mg 9 to 80† (20 mg, #30) No/yes
Paroxetine (Paxil, Paxil CR) 20 to 50 mg (25 to 62.5 mg [CR]) 50 to 82† (20 mg, #30), 104 (25 mg [CR], #30) Yes/yes
Sertraline (Zoloft) 50 to 200 mg 13 to 86† (50 mg, #30) No/yes
SNRIs
Duloxetine (Cymbalta) 30 to 90 mg 121 (30 mg, #30) Yes/avoid
Venlafaxine, extended release (Effexor XR) 37.5 to 225 mg 110 (75 mg, #30) Yes/yes
  • *— Estimated cost to the pharmacist based on average wholesale prices
  • †— Denotes generic (Keller 1).

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