Depression and comorbid medical illness: therapeutic and diagnostic challenges.

Abstract

It is estimated that major depressive disorder exists in 36% of patients with coexistent medical conditions and may be more common in hospitalized and elderly patients. 1 This discussion addresses comorbidities in patients with depression and provides treatment strategies for clinicians. Absent in the general discussion are the tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These agents may have value in treating specific comorbid illnesses (ie, chronic pain syndromes); however, their toxicity makes them inappropriate as first-line medications for depression.