Page 60 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

1.8.12 Reassess the risk of relapse for people who continue with psychological therapy

to prevent relapse, when they are finishing the relapse prevention treatment,
and assess the need for any further follow up. [2022] [2022]

For a short explanation of why the committee made these recommendations and how they
might affect practice, see the rationale and impact section on preventing relapse.

Full details of the evidence and the committee's discussion are in evidence review C:
preventing relapse.

1.9 1.9 Further-line treatment Further-line treatment

1.9.1 If a person's depression has not responded at all after 4 weeks of antidepressant
medication at a recognised therapeutic dose, or after 4 to 6 weeks for
psychological therapy or combined medication and psychological therapy,

discuss with them:

• whether there are any personal, social or environmental factors or physical or other
mental health conditions that might explain why the treatment is not working

• whether they have had problems adhering to the treatment plan (for example,
stopping or reducing medication because of side effects, or missing sessions with their

therapist).

If any of these are the case, make a shared decision with the person about the best way
to try and address any problems raised, including how other agencies may be able to

help with these factors. See the visual summary on further-line treatment. [2022] [2022]

1.9.2 If a person's depression has not responded to treatment after addressing any
problems raised (see recommendation 1.9.1), and allowing an adequate time for
treatment changes to work, review the diagnosis and consider the possibility of
alternative or comorbid conditions that may limit response to depression
treatments. [2022] [2022]

1.9.3 Reassure the person that although treatment has not worked, other treatments
can be tried, and may be effective. [2022] [2022]

1.9.4 If a person's depression has had no or a limited response to treatment with

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