Adult Depression A step-by-step guide to treatment – MM1605
A stepwise approach to the early detection and management of depression, guided by severity of presentation and treatment response, encourages more timely access to evidence-based treatments, including easily accessed and destigmatising e-mental health interventions. Evidence-based treatments range from e-mental health apps, psychological therapy and medication to neurostimulation.
With the overall similarities in efficacy of antidepressants, the most important considerations when initiating pharmacotherapy are tolerability and safety. For patients with difficult-to-treat depression, an algorithmic management approach with steps that include increasing the antidepressant dose, switching antidepressants, augmenting with a non-antidepressant treatment and combining antidepressants improves the chance of patient recovery. Neurostimulatory treatments such as electroconvulsive therapy and repetitive transcranial magnetic stimulation have an expanding role in the evidence based treatment of severe depression.
Modern Medicine – May 2016
