Page 67 - Depression in adults: treatment and management

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Depression in adults: treatment and management (NG222)

• use a validated measure of prospective mood monitoring or a symptom checklist or

chart to assess response, or any exacerbation of emotional instability

• extend the duration of treatment if needed, up to a year. [2022] [2022]

1.11.4 For people with depression and a diagnosis of personality disorder, consider
referral to a specialist personality disorder treatment programme. See the NICE

guideline on borderline personality disorder for recommendations on treatment
for borderline personality disorder with coexisting depression. [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 depression in people with a
diagnosis of personality disorder.

Full details of the evidence and the committee's discussion are in evidence review F:
depression with coexisting personality disorder.

1.12 1.12 Psychotic depression Psychotic depression

In June 2022, use of antipsychotics for the treatment of depression was an off-label use for some
antipsychotics. See NICE's information on prescribing medicines.

1.12.1 Offer referral to specialist mental health services for people with depression
with psychotic symptoms, where the treatment should include:

• a risk assessment

• an assessment of needs

• a programme of coordinated multidisciplinary care

• access to psychological treatments, after improvement of acute psychotic symptoms.

Discuss treatment options and, for those people who have capacity, reach a shared

decision based on their clinical needs and preferences. See the visual summary on
treatment of psychotic depression. [2022] [2022]

1.12.2 Consider combination treatment for people with depression with psychotic
symptoms with antidepressant medication and antipsychotic medication (for

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