Psychopharmacological Treatment of Major Depression

This article provides an overview of the medication issues and concerns that social workers may encounter when participating in the treatment of clients who suffer from major depression. This overview includes information about the condition of major depression, the medications used to treat this disorder, their short- and long-term efficacy, side effects, and other important considerations for effective social work. For many social workers, clients with serious symptoms of depression are commonly encountered. Reporting of these symptoms happens so often in the routine course of treatment that many refer to depression as the common cold of mental health. Each year it is estimated that 1.5 million individuals receive treatment for unipolar depression and yet still another 4.5 to 7.5 million people go untreated (Merck Research Laboratories, 1992). Of the clients who seek treatment to address their depression, it is further noted that 50 % to 80 % go unrecognized or misdiagnosed (Higgins, 1994). In clinical practice, it is estimated that only approximately 25 % of the individuals who suffer from serious depression actually go to an inpatient mental health setting for treatment, whereas the remainder go directly to outpatient or other private practice medical settings (Merck Research Labo-ratories, 1992). In the primary care medical setting, up to 30 % of all patients report having depressive symptoms (Tierney, McPhee, & Papadakis, 1997). Yet, physicians often find it frustrating to deal with these patients, as their complaints (often somatic in nature) usually result in negative medical workups. Addressing this multifaceted disorder is fertile ground for misun-derstanding and frustration on the part of both health care providers and th