| Depressive Disorders (Major Depressive Disorder, Dysthymic Disorder)
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| Suggested Pre-Referral Evaluation and Management Guidelines |
Rule out medical causes of the symptoms, especially thyroid and other endocrine diseases, or effects of medications (such as steroids, contraceptives, psychoactive substances).
Most depressive disorders can be treated by either medication or psychotherapy or both in combination. Patient preference is important. Inform patients that initial side effects often pass within a week or so and that further dose increases and at least 4-8 weeks may be required to achieve a good medication trial. Using too low of a dose or too short of a trial are common reasons for a poor response to medication. Try to raise the dose to at least moderate levels for at least 4 weeks.
Consult UMHS treatment guidelines for depression for suggestions regarding medication selection.
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| Suggested Additional Test/Management Prior to Specialty Visit |
If the patient does not respond to or tolerate the first antidepressant that is tried, it is worth trying another before referring for specialty care. It is sometimes desirable to try a second medication from another class of antidepressants, unless co-morbid anxiety is prominent, in which case a second trial of an SSRI may be best.
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| Patient Education/Information (includes preps) |
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| Appointment Timeframe |
Routine evaluations usually available in 2-6 weeks.
We have little capacity to meet urgent care needs.
For Emergent care direct to Psychiatric Emergency Service 734-936-5900
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| How to Get Results to Consultant |
UMHS Patients: Make sure all needed information is posted or scanned in to CareWeb
External Patients: Fax referral request form and supporting patient records. Fax: 734-763-5580
Records should be mailed or faxed well in advance of scheduled consultations. If time frame is too short, patients can hand carry outside records. |
| Clinic Contact Information |
UMHS patients:
- Complete the consult request form and image into CareWeb.
- Direct the patient to call Psychiatry Intake & Call Center at 734-764-0231 or 1-800-525-5188 to make an appointment.
Clinic General Information: 734-764-5348
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| Clinic Location Sites |
Depression Center / Ambulatory Psychiatry at the Rachel Upjohn Building |
| UM Consulting Physician |
Depressive Disorders Section Faculty
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| Revised on: |
07/08/2009 |
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