Page 87 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

There was some limited evidence that people with depression wanted information about how and

when they would be monitored when prescribed antidepressants, and that they appreciated being
able to self-monitor their symptoms as this was empowering. There was also some limited evidence
that, when planning to stop medication, tapering antidepressants may reduce withdrawal effects.
The committee used their knowledge to add more detail to the recommendations on techniques for
tapering, drugs that may be associated with more withdrawal symptoms, and those which could be

tapered more quickly such as fluoxetine.

There was evidence on the range of adverse effects that people experienced when withdrawing

from antidepressants, but the committee agreed that more detailed information on incidence and
severity for specific interventions would be useful to inform patient choice and so they made a
research recommendation on stopping antidepressants. There was evidence on the information
needs and support needs of people with depression, that showed that people would like to receive
realistic information about the potential benefits and harms of antidepressants, how long they will

take to work, the length of treatment and the process of withdrawal. The evidence also showed
they value support from healthcare professionals when withdrawing from medication, including a
recognition of their fears and concerns about the withdrawal process.

How the recommendations might affect practice How the recommendations might affect practice

The recommendations reflect current practice, but may reduce variation in practice across the
NHS.

Return to recommendations

Use of lithium as augmentation Use of lithium as augmentation

Recommendations 1.4.28 to 1.4.31, 1.4.33 and 1.4.34

Why the committee made the recommendations Why the committee made the recommendations

The committee made the recommendations on the use of lithium by informal consensus and based
on their knowledge and experience and in line with the monitoring requirements specified in the

BNF.

How the recommendations might affect practice How the recommendations might affect practice

The recommendations reflect current practice, but may reduce variation in practice across the

NHS.

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