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Major depressive disorder treatment guidelines in America and Europe.

Publication ,  Journal Article
Davidson, JRT
Published in: J Clin Psychiatry
2010

The various major American and European guidelines for the treatment of depression provide similar basic principles of treatment, which include individualizing the treatment plan, preparing the patient for potential long-term treatment, providing measurement-based care, and treating to remission. While the guidelines are all evidence-based, certain factors can influence differences in specific recommendations, such as the consensus group's composition, underlying mandates, and cultural attitudes. The similarities and differences among 6 sets of guidelines from Europe and the Americas published in the past decade are reviewed here (American Psychiatric Association, British Association for Psychopharmacology, Canadian Network for Mood and Anxiety Treatments, National Institute for Health and Clinical Excellence, Texas Medication Algorithm Project, and World Federation of Societies of Biological Psychiatry). In the guidelines, mild depression has the most variance in treatment recommendations; some, but not all, guidelines suggest that it may resolve with exercise or watchful waiting, but psychotherapy or antidepressants could be used if initial efforts fail. Moderate and severe major depression carry broadly similar recommendations among the guidelines. First-line treatment recommendations for moderate major depressive disorder include antidepressant monotherapy, psychotherapy, and the combination of both. Severe depression may require the combination of an antidepressant and an antipsychotic, electroconvulsive therapy, or the combination of an antidepressant and psychotherapy. Benzodiazepines play a very limited role in the treatment of depression; if the patient has catatonic depression, acutely suicidal depression, or depression with symptoms of anxiety, agitation, or insomnia, benzodiazepines are recommended by some guidelines for short-term treatment only.

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Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

2010

Volume

71 Suppl E1

Start / End Page

e04

Location

United States

Related Subject Headings

  • United States
  • Secondary Prevention
  • Psychotherapy
  • Psychiatry
  • Practice Guidelines as Topic
  • Humans
  • Evidence-Based Medicine
  • Europe
  • Electroconvulsive Therapy
  • Depressive Disorder, Major
 

Citation

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MLA
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Davidson, J. R. T. (2010). Major depressive disorder treatment guidelines in America and Europe. J Clin Psychiatry, 71 Suppl E1, e04. https://doi.org/10.4088/JCP.9058se1c.04gry
Davidson, Jonathan R. T. “Major depressive disorder treatment guidelines in America and Europe.J Clin Psychiatry 71 Suppl E1 (2010): e04. https://doi.org/10.4088/JCP.9058se1c.04gry.
Davidson JRT. Major depressive disorder treatment guidelines in America and Europe. J Clin Psychiatry. 2010;71 Suppl E1:e04.
Davidson, Jonathan R. T. “Major depressive disorder treatment guidelines in America and Europe.J Clin Psychiatry, vol. 71 Suppl E1, 2010, p. e04. Pubmed, doi:10.4088/JCP.9058se1c.04gry.
Davidson JRT. Major depressive disorder treatment guidelines in America and Europe. J Clin Psychiatry. 2010;71 Suppl E1:e04.

Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

2010

Volume

71 Suppl E1

Start / End Page

e04

Location

United States

Related Subject Headings

  • United States
  • Secondary Prevention
  • Psychotherapy
  • Psychiatry
  • Practice Guidelines as Topic
  • Humans
  • Evidence-Based Medicine
  • Europe
  • Electroconvulsive Therapy
  • Depressive Disorder, Major