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Antidepressants, serotonergic class; 3-5

CPT4 code

Name of the Procedure:

Antidepressants, Serotonergic Class (SSRIs, SNRIs)

Summary

Antidepressants of the serotonergic class, commonly known as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors), are medications that help increase the levels of serotonin and norepinephrine in the brain to improve mood and alleviate symptoms of depression.

Purpose

Condition:

  • Major Depressive Disorder (MDD), Anxiety Disorders, Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-Traumatic Stress Disorder (PTSD) Goals:
  • Improve mood, reduce anxiety, enhance emotional well-being, and help improve the patients' overall functionality in daily life.

Indications

Specific Symptoms:

  • Persistent sadness, loss of interest or pleasure in activities, anxiety, panic attacks Patient Criteria:
  • Diagnosed with depressive disorder or anxiety-related conditions, unresponsive to other forms of treatment such as psychotherapy alone

Preparation

Instructions:

  • Inform healthcare provider of all current medications and supplements
  • Follow a consistent medication schedule as prescribed Assessments:
  • Physical examination, medical history review, possibly blood tests to rule out other causes of symptoms

Procedure Description

Step-by-Step:

  1. Patient meets with a healthcare provider to discuss symptoms and medical history
  2. A prescription for an SSRI or SNRI is provided based on individual needs
  3. Patient starts with a low dose which may be gradually increased
  4. Regular follow-up appointments to monitor effects and adjust dosage if necessary Equipment:
    • No specialized tools or technology required, only oral medication Anesthesia:
    • Not applicable

Duration

Typical Duration:

  • Initial effects may be noticed within 1-2 weeks, full therapeutic effects often take 4-6 weeks

Setting

Performed At:

  • Outpatient setting, prescribed during a regular doctor's visit or psychiatric consultation

Personnel

Healthcare Professionals Involved:

  • Primary care physician, psychiatrist

Risks and Complications

Common Risks:

  • Nausea, headache, dry mouth, sleep disturbances, sexual dysfunction Rare Risks:
  • Increased risk of suicidal thoughts, serotonin syndrome, discontinuation syndrome if not tapered properly

Benefits

Expected Benefits:

  • Reduction in depressive symptoms and anxiety, improved quality of life Time Frame:
  • Initial improvement within a few weeks, with ongoing benefits as treatment continues

Recovery

Post-Procedure Care:

  • Regular medication intake, follow-up appointments with healthcare provider Recovery Time:
  • No physical recovery period, but continuous monitoring for side effects and effectiveness
  • Possibly lifelong or long-term management

Alternatives

Other Options:

  • Psychotherapy, other classes of antidepressants (e.g., tricyclics, MAO inhibitors), lifestyle changes, electroconvulsive therapy (for severe cases) Pros and Cons:
  • Psychotherapy: no medication side effects but may not be sufficient alone for severe cases
  • Other Antidepressants: different side effect profiles
  • Lifestyle Changes: supportive but may not address severe chemical imbalances

Patient Experience

During Procedure:

  • Daily intake of prescribed medication After Procedure:
  • May experience side effects initially which often subside; regular communication with healthcare provider Pain Management:
  • Not typically required; side effects managed through dose adjustment or additional medications as needed

Medical Policies and Guidelines for Antidepressants, serotonergic class; 3-5

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