Depression

Summary of NICE Clinical Guideline 90: treatment for depression

1. Antidepressants are not recommended as a first-line treatment in recent-onset, mild depression; active monitoring, individual guided self-help, CBT and/or exercise are preferred.

2. Antidepressants are recommended for the treatment of moderate-to-severe depression and for dysthymia.

3. When an antidepressant is prescribed, a generic selective serotonin reuptake inhibitor (SSRI) is recommended.

4. All patients should be informed about the withdrawal (discontinuation) effects of antidepressants.

5. For treatment-resistant depression, recommended strategies include augmentation with lithium or an antipsychotic or the addition of a second antidepressant .

6. Patients with two prior episodes and functional impairment should be treated for at least 2 years.

7. The use of ECT is supported in severe and treatment-resistant depression.