Page 57 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

For a short explanation of why the committee made this recommendation and how it might
affect practice, see the rationale and impact section on behavioural couples therapy.

Full details of the evidence and the committee's discussion are in evidence review B:
treatment of a new episode of depression.

1.8 1.8 Preventing relapse Preventing relapse

1.8.1 Discuss with people that continuation of treatment (antidepressants or
psychological therapies) after full or partial remission may reduce their risk of
relapse and may help them stay well. Reach a shared decision on whether or not

to continue a treatment for depression based on their clinical needs and
preferences. See the visual summary on preventing relapse. [2022] [2022]

1.8.2 Discuss with people that the likelihood of having a relapse may be increased if
they have:

• a history of recurrent episodes of depression, particularly if these have occurred
frequently or within the last 2 years

• a history of incomplete response to previous treatment, including residual symptoms

• unhelpful coping styles (for example, avoidance and rumination)

• a history of severe depression (including people with severe functional impairment)

• other chronic physical health or mental health problems

• personal, social and environmental factors that contributed to their depression (see
recommendation 1.2.7) and that are still present (for example, relationship problems,

ongoing stress, poverty, isolation, unemployment). [2022] [2022]

1.8.3 Discuss with people the potential risks of continuing with antidepressants long
term, and how these balance against the risks of depression relapse. These
include:

• possible side effects, such as an increased bleeding risk or long-term effects on sexual

function

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