Severe Depression Treatment {Ans: (1) Antidepressant + psychiatric referral and/or hospitalization and/or ECT Primary options: citalopram, escitalopram, fluoxetine, paroxetine, sertraline, desvenlafaxine, duloxetine, levominacipran, venlafaxine, buproprion hydrochloride, mirtazapine, vilzodone, vortioxetine (2) Can add immediate sx management with benzo and/or APS Lorazepam, clonazepam, risperidone, olanzapine, quetiapine, fluphenazine, trazodone (3) Switch to alternative antidepressant}Lithium toxicity {Ans: Toxicity can occur at levels > 1.2 mEq/L 1) Acute Toxicity (1) Acute lithium toxicity occurs when someone not prescribed lithium but ingests it. Acute toxicity may carry less medical risk and less severe symptoms than the other types, depending on the amount taken, because lithium will clear out of your body more quickly when your system is not used to it 2) Chronic Toxicity (1) The chronic form of toxicity occurs when you take lithium daily, but your levels are at a toxic level. Possible causes are a dosage increase, being dehydrated, interactions with other medications, or problems with kidney function. This type of toxicity is less likely to be detected early than the other types, so more severe symptoms may appear before it's identified. Medications that can contribute to dehydration or cause your kidneys not to function as well as normal include diuretics,