Page 68 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

example, olanzapine or quetiapine). [2022] [2022]

1.12.3 If a person with depression with psychotic symptoms does not wish to take
antipsychotic medication in addition to an antidepressant, then treat with an
antidepressant alone. [2022] [2022]

1.12.4 Monitor people with depression with psychotic symptoms for treatment
response (in particular for unusual thought content and hallucinations). [2022] [2022]

1.12.5 Consider continuing antipsychotic medication for people with depression with
psychotic symptoms for a number of months after remission, if tolerated. The
decision about if and when to stop antipsychotic medication should be made by,
or in consultation with, specialist services. [2022] [2022]

1.12.6 For more advice on prescribing and monitoring antipsychotics see the
recommendations on use of oral antipsychotics as augmentation and the NICE
guideline on psychosis and schizophrenia in adults. [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 psychotic depression.

Full details of the evidence and the committee's discussion are in evidence review G: psychotic
depression.

1.13 1.13 Electroconvulsive therapy for depression Electroconvulsive therapy for depression

1.13.1 Consider electroconvulsive therapy (ECT) for the treatment of severe

depression if:

• the person chooses ECT in preference to other treatments based on their past
experience of ECT and what has previously worked for them or or

• a rapid response is needed (for example, if the depression is life-threatening because
the person is not eating or drinking) or or

• other treatments have been unsuccessful (see the recommendations on further-line
treatment). [2022] [2022]

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