Page 3 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

Contents Contents

Overview .......................................................................................................................................................................... 5

Who is it for? ................................................................................................................................................................................. 5

Recommendations ........................................................................................................................................................ 6

1.1 Principles of care .................................................................................................................................................................. 7

1.2 Recognition and assessment ........................................................................................................................................... 9

1.3 Choice of treatments ......................................................................................................................................................... 13

1.4 Delivery of treatments ...................................................................................................................................................... 14

1.5 Treatment for a new episode of less severe depression ...................................................................................... 27

1.6 Treatment for a new episode of more severe depression ................................................................................... 44

1.7 Behavioural couples therapy for depression ............................................................................................................ 56

1.8 Preventing relapse .............................................................................................................................................................. 57

1.9 Further-line treatment ...................................................................................................................................................... 60

1.10 Chronic depressive symptoms ..................................................................................................................................... 64

1.11 Depression in people with a diagnosis of personality disorder ...................................................................... 66

1.12 Psychotic depression ....................................................................................................................................................... 67

1.13 Electroconvulsive therapy for depression .............................................................................................................. 68

1.14 Transcranial magnetic stimulation for depression .............................................................................................. 71

1.15 Implanted vagus nerve stimulation for treatment-resistant depression ................................................... 71

1.16 Access, coordination and delivery of care ............................................................................................................... 71

Terms used in this guideline .................................................................................................................................................... 77

Recommendations for research .............................................................................................................................. 82

Key recommendations for research .................................................................................................................................... 82

Other recommendations for research ................................................................................................................................ 84

Rationale and impact ................................................................................................................................................... 86

Choice of treatments ................................................................................................................................................................. 86

Starting and stopping antidepressants ............................................................................................................................... 86

Use of lithium as augmentation ............................................................................................................................................. 87

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