Topic overview

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MDD diagnosis requires at least five of nine SIGECAPS symptoms for at least two weeks, including depressed mood or loss of interest or pleasure, with functional impairment. The topic reviews monoamine, HPA-axis, genetic, and inflammatory factors implicated in its pathophysiology. SSRIs and SNRIs are first-line drug classes, with selection guided by comorbidities, prior response, adverse-effect profile, and interactions. Counseling and follow-up address delayed treatment benefit, early adverse effects, continuation after remission, and gradual tapering. The lesson also compares other antidepressant classes, highlights serious safety concerns such as serotonin syndrome and suicidality, and introduces augmentation and non-pharmacologic interventions for selected cases.