Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Approaches 1 — Questions and Answers
Question 1: Which class of antidepressants is considered a first-line pharmacological treatment for Persistent Depressive Disorder in the US?
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Antipsychotics
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the preferred first-line pharmacotherapy for PDD due to their favorable safety and tolerability profile.
Question 2: Which psychotherapy has the strongest evidence base for treating Persistent Depressive Disorder, specifically developed for chronic depression?
- Psychodynamic therapy
- Cognitive Behavioral Analysis System of Psychotherapy (CBASP) (Correct answer)
- Dialectical Behavior Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Correct answer: Cognitive Behavioral Analysis System of Psychotherapy (CBASP)
CBASP was specifically designed and validated for chronic depression including PDD, making it the most evidence-based psychotherapy for this condition.
Question 3: Research shows that the most effective treatment for PDD combines which two modalities?
- Two different SSRIs simultaneously
- Antidepressant medication plus psychotherapy (Correct answer)
- Cognitive therapy plus light therapy
- MAOI plus TCA
Correct answer: Antidepressant medication plus psychotherapy
Studies consistently show combined antidepressant pharmacotherapy plus psychotherapy produces superior outcomes to either treatment alone for PDD.
Question 4: Which SNRI is commonly used as an alternative to SSRIs for treating PDD?
- Bupropion
- Venlafaxine (Correct answer)
- Mirtazapine
- Trazodone
Correct answer: Venlafaxine
Venlafaxine, an SNRI, is a commonly used alternative to SSRIs for PDD and has demonstrated efficacy in chronic depression.
Question 5: How long should pharmacotherapy typically be continued in PDD to prevent relapse?
- 3-6 months after remission
- At least 1 year or indefinitely given chronicity (Correct answer)
- Only until symptoms resolve
- Maximum 2 years
Correct answer: At least 1 year or indefinitely given chronicity
Given PDD's chronic nature, guidelines recommend continuing pharmacotherapy for at least 1 year after remission, often indefinitely.
Question 6: Which augmentation strategy is evidence-supported when an SSRI alone is insufficient for PDD?
- Adding lithium or an atypical antipsychotic (Correct answer)
- Switching to a benzodiazepine
- Adding a stimulant permanently
- Stopping all medication and using therapy only
Correct answer: Adding lithium or an atypical antipsychotic
Augmenting SSRIs with lithium or atypical antipsychotics such as aripiprazole is a supported strategy for treatment-resistant PDD.
Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Approaches 1
Which class of antidepressants is considered a first-line pharmacological treatment for Persistent Depressive Disorder in the US?