Anthony Rothschild, MD, Discusses the Challenges of Diagnosing Depression with New Anti-Depressants

Anthony Rothschild, MD, a professor at the Irving S. and Betty Brudnick Endowed Chair of Psychiatry, University of Massachusetts Medical School, says that many primary care physicians feel more comfortable prescribing newer anti-depressant drugs with fewer side effects.

He adds that patients who are diagnosed with depression for the 1st time are often done so by their primary care physician. This is because he or she may not have believed they were suffering from depression and would not have previously considered contacting a psychiatrist. Physicians are in a “unique position” to diagnose patients with depression and to prescribe an anti-depressant drug regimen.

However, Dr Rothschild explains that there are certain types of depression that should not be handled by primary care physicians alone. He recommends that primary care physicians refer patients who suffer from conditions such as psychotic depression or bipolar disorder to a psychiatrist, as they can be more complicated.

“It’s not unusual for me to see patients with depression who may have had 1 trial of an anti-depressant from their primary care physician,” Dr Rothschild says. “If it works out, I don’t ever see them. But, if it doesn’t work out then and it becomes a little more complicated, then the primary care doctor will refer the patient to a psychiatrist.”

Dr Rothschild also serves as director at the UMass Medical Depression Center and Center for Psychopharmacologic Research and Treatment, and as a program director at the Mood Disorders Comprehensive Consultation Clinic at UMass Memorial Medical Center.