Dawaa Reference

Clinical reference

Feeling Sad

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) - condition scope only, no dose · Major Depressive Disorder - StatPearls - NCBI Bookshelf (NBK559078) - https://www.ncbi.nlm.nih.gov/books/NBK559078/ · No dose - no medicine is given for this in primary care

Verified against1 document
  • No dose - no medicine is given for this in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (10)

  • Open with the bodily symptoms: sleep, appetite and energy
  • Five of nine symptoms are needed, one of them low mood or loss of interest and pleasure [loss of interest · low mood]
  • Low mood [low mood]
  • Less interest or pleasure in things
  • Disturbed sleep
  • Guilt, or a sense of being worthless
  • Altered energy or frank fatigue [fatigue]
  • Poor concentration and attention [poor concentration]
  • Change in appetite or in weight
  • Thoughts of suicide

Signs — what you find (2)

  • Movement is disturbed, either slowed or agitated [irritability]
  • The diagnosis rests on the history and the examination findings

Tests (12)

  • Every patient needs assessing for suicide risk, and any risk needs acting on at once
  • Take past and family medical history, and list current medicines
  • Take a social history centred on stressors and on drug and alcohol use
  • History and examination serve to rule out physical causes of the low mood
  • Standard depression questionnaires help gauge which symptoms are present and how severe
  • No blood test diagnoses it; the tests exist to exclude illnesses that imitate it
  • Blood count, thyroid-stimulating hormone and vitamin B12
  • Syphilis serology and an HIV test
  • Electrolytes with calcium, phosphate and magnesium; urea and creatinine; liver tests
  • Blood alcohol level, and toxicology screening of blood and urine
  • Dexamethasone suppression looks for Cushing disease, though depression itself can make it positive
  • An ACTH stimulation test looks for Addison disease; brain CT or MRI if organic brain disease or hypopituitarism is in question

If not this — what else fits (9)

  • Adjustment disorder
  • Underlying anaemia
  • Chronic fatigue syndrome
  • A dissociative disorder
  • Illness anxiety disorder
  • Low blood sugar
  • Underactive pituitary
  • Schizoaffective disorder, or schizophrenia
  • Somatic symptom disorder

SourceStatPearls "Depression" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (ASSESSMENT & ADVICE)

1st line
Adult dose and duration

Everyday sadness or low mood reported by the patient without meeting criteria for a mental disorder; the GP's role is listening, exploring the cause, and distinguishing this from clinical depression, which is coded and treated separately. No medication is indicated for normal sadness itself. - Assessment and advice

Paediatric dose

Children follow the same pathway: assessment, explanation and follow-up. No primary-care medicine is implied.

Dose source

No dose - no medicine is given for this in primary care

Why

Everyday sadness or low mood reported by the patient without meeting criteria for a mental disorder; the GP's role is listening, exploring the cause, and distinguishing this from clinical depression, which is coded and treated separately. No medication is indicated for normal sadness itself.

Cautions
  • No medicine is prescribed for this in primary care. The value of the consultation is recognition, explanation and follow-up, and referral if the red flags above appear.
  • RED FLAG - Symptoms persisting beyond two weeks with loss of interest or function, suggesting a major depressive episode rather than simple sadness, or any expression of hopelessness or suicidal thoughts.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.