Pamela Lusk, DNP, RN, PMHNP-BC: The Optimal Way to Treat Depression

Finding the right combination of therapy and medication to treat depression is challenging for doctors, especially when the patient is younger. There are many different types of therapies to be used in conjunction with the variety of antidepressants available.

In an interview with MD Magazine® during the 2^nd Annual Advanced Practice Collaborative, Pamela Lusk, DNP, RN, PMHNP-BC, a clinical associate professor at the Ohio State University College of Nursing, explained what the best practices are in dealing with adolescents with a depression diagnosis.

MD Mag: What are some of the most effective new treatments for depression?

Lusk: It seems like all of the studies are still coming in that with mild and early moderate depression, the best evidence-based treatment is supportive monitoring, it's cognitive behavior therapy, interpersonal therapy. So, using the psychological therapies first.

When it's moderate to major depressive disorder, meets the criteria for a major depressive disorder, then the most effective treatment is the psychological treatments, the therapy, as well as some antidepressant medication. And we're still depending on the serotonin reuptake inhibitors like Prozac as the first-line medications in combination with therapy.

MD Mag: What are some of the most effective new treatments for depression?

Lusk: I like the American Academy of Pediatrics guidelines for the treatment of adolescent depression. I like that you start with therapy and in my practice, I continue the therapy through. I always do the combination of therapy and medication if medications indicated, because you still have that relationship and you're still able to monitor people very closely, weekly, bi-weekly. And so it's just a good combination if you do both together if medications are warranted.

MD Mag: What is the difference in how depression is treated based on the age of the patient?

Lusk: The guidelines are still the same, if it's mild depression we still use supportive follow-up and counseling first. So, the difference between age groups, I started doing cognitive behavior therapy with about 6- and 7-year olds. We use treatment manuals.

They're very quick visits—30-minute visits and so as you can imagine the manuals very developmentally appropriate for school-aged children. The examples are school-age children with the teenagers. We use another manual, same program, but the examples are more developmentally appropriate for adolescents.

The medications are still the same ones, they're approved usually about age 7 all the way up. So, the medication is about the same. We have liquid SSRIs for younger ones.