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CME
Treating Depressive Disorders
 
Atypical Depression
Level of Evidence Place in Therapy Medication Usual Daily Dose1 Cost per
Day2
Level I Evidence and generally tolerable side effect/safety profile. 1st choice Only phenelzine and imipramine meet criteria for Level I evidence but are not recommended as first choice treatment due to the significant side effect and safety concerns, drud interactions, and the need for dietary restrictions.
Level II evidence or Level I evidence but less tolerable side effect/safety profile. 2nd choice FLUOXETINE
(Prozac) 		20-40 mg $1.08-2.16
SERTRALINE
(Zoloft) 		50-150 mg $1.60-3.35
MOCLOBEMIDE
(Manerix) 		450-600 mg $1.22-2.28
Level III evidence or Level I/II evidence and significantly less tolerable side effect/safety profile. 3rd choice PHENELZINE3
(Nardil) 		30-75 mg $0.60-1.50
IMIPRAMINE
(Tofranil) 		100-250 mg $0.04-0.09

NOTE: Non-responding patients should be switched to an alternative 1st choice agent prior to attempting a 2nd choice antidepressant.

 

1. Usual daily doses are provided unless otherwise stated. Consult the drug monograph for details on age and condition specific dosing.
2. Approximate costs were derived from the ODB formulary (#36) or manufacturers' price lists and do not include professional fees or markups.
3. Food and drug restrictions apply. Two-week washout required after discontinuation.

From: CANMAT - Guidelines for the Diagnosis and Pharmacological Treatment of Depression (1st Edition Rev., 1999) Page 21.

Back to Treating Depressive Disorders

Back to Managing Depressive Disorders - (Selections from: CANMAT - Guidelines for the Diagnosis and Pharmacological Treatment of Depression [1st Edition Rev., 1999])

 

 
 


Over one million Canadians suffer from some form of depressive illness.