Depression and its Dilemma

Abstract

Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration. Depression shall become the second largest illness in terms of morbidity by another decade. 50-65% of patients respond to the first antidepressant. No particular antidepressant agent is superior to another in efficacy or time to response. Depression is less prevalent among older adults than among younger adults but can have serious consequences. Choice can be guided by matching patients’ symptoms to side effect profile, presence of medical and psychiatric co morbidity. The adequate treatment of residual symptoms following an acute depressive episode, including insomnia symptoms, may prevent relapse. In the near future, developments are likely to remain focused on monoamine neurotransmitters, with the aim of finding agents that are either more effective, better tolerated or that have a faster onset of action than existing options.