3.4) Choice of antidepressant.
The Cochrane review we conducted showed that antidepressants are more effective than acebo in treating depressed patients with physical illness, including those with 'life threatening physical illness. Though there is no evidence that any particular antidepressant is preferable for palliative patients, a recent
meta-analysis in physically well people antidepressants are indicated that some second generation marginally more effective and better tolerated than others. We recommend, therefore, that clinicians become familiar antidepressant with two or three of the better performing. Tricyclic antide pressants pose greater risk in overdose than ssRIs and are of ten contraindicated in palliative care patients due to heart disease, liver failure or prostatic hypertrophy. However, ami antidepressant is potential triptyline and other tricyclic medicines, which may be useful for patients with second-line neuropathic pain Given the lack of evidence for a clearly antidepressant, choice of drug should be based on superior the type of comorbid physical illness, the patient's symptom interactions and contraindica profile, potential side-effects, tions, clinician familiarity and patient preference.
3.3.5. Before initiating treatment Clinicians should discuss the different treatment options with the patient and take into account their preferences and the outcome of previous treatments. Patients should be informed about potential side-effects of antidepressant drugs, discontinuation symptoms, possible delay in onset of effect, and the need to take medication as preseribed, even
3.4) Choice of antidepressant. The Cochrane review we conducted showed that antidepressants are more effective than acebo in treating depressed patients with physical illness, including those with 'life threatening physical illness. Though there is no evidence that any particular antidepressant is preferable for palliative patients, a recent meta-analysis in physically well people antidepressants are indicated that some second generation marginally more effective and better tolerated than others. We recommend, therefore, that clinicians become familiar antidepressant with two or three of the better performing. Tricyclic antide pressants pose greater risk in overdose than ssRIs and are of ten contraindicated in palliative care patients due to heart disease, liver failure or prostatic hypertrophy. However, ami antidepressant is potential triptyline and other tricyclic medicines, which may be useful for patients with second-line neuropathic pain Given the lack of evidence for a clearly antidepressant, choice of drug should be based on superior the type of comorbid physical illness, the patient's symptom interactions and contraindica profile, potential side-effects, tions, clinician familiarity and patient preference. 3.3.5. Before initiating treatment Clinicians should discuss the different treatment options with the patient and take into account their preferences and the outcome of previous treatments. Patients should be informed about potential side-effects of antidepressant drugs, discontinuation symptoms, possible delay in onset of effect, and the need to take medication as preseribed, even
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