Clinical practice recommendations for depression

Abstract

These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation.

Pharmacological Treatment Following Traumatic Bereavement: A Case Series

“…Even when a diagnosis of a disorder has been made following bereavement, research suggests that medication should be only one component of treatment. For instance, based on a review of more than 500 articles on depression, Malhi et al (2009) recommended a careful process of evidence-based intervention. First, ensure subject safety and education and Pharmacology and Grief: Case Series 573 establish a therapeutic relationship.…”

Atypical Antipsychotic Augmentation Strategies in the Context of Guideline-based Care for the Treatment of Major Depressive Disorder

“…Among atypical antipsychotics, aripiprazole is considered to have high quality evidence; however, it is noted that meta-analyses have not found differences in efficacy between atypical antipsychotics [5,25,26]. The CPR for depression was published in Australia [12]. Therapeutic strategies to manage partial or nonresponse to initial antidepressant treatment include dose optimization, augmentation, combination, substitution (switching) or ECT.…”

“…Unfortunately, varying definitions of treatment-resistant depression, the limited evidence available for interventions after two or more treatment failures, and when and whether to use medications from nonantidepressant classes, remain a key gap in the evidence base leaving clinicians uncertain as to how to proceed with their patients with treatment-resistant depression. We identified and reviewed the following guidelines to discuss the status of augmentation therapy with atypical antipsychotic agents in MDD: American Psychiatric Association Practice Guidelines for treatment of patients with MDD [6,7]; Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of MDD in adults [8]; National Institute for Health and Clinical Excellence (NICE) guidelines for treatment and management of depression in adults [9]; British Association of Psychopharmacology (BAP) guidelines for treatment of depressive disorders [10]; Institute for Clinical Systems Improvement (ICSI) healthcare guideline for MDD in adults in primary care [11]; clinical practice recommendations (CPR) for depression [12]; international consensus statement (ICS) on MDD [13]; the German Society of Psychiatry, Psychotherapy and Neurology (DGPPN) guidelines for unipolar depression [14]; and World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders in primary care [15].…”

Intensive Short-Term Dynamic Psychotherapy Associated with Decreases in Electroconvulsive Therapy on Adult Acute Care Inpatient Ward

“…It should also study a specific patient diagnosis, such as depression, in order to allow replication. In the interim, brief talking approaches such as this should be implemented prior to ECT delivery based on recent treatment guidelines [1]. …”

“…The emotions triggered by these events often induce depression, anxiety, psychotic phenomena and acting-out behavior. Electroconvulsive therapy (ECT) may be an effective tertiary treatment for select patients who fail to respond to first- and second-line guideline-driven treatment options for severe depression [1]. …”