Antidepressants do work in depression while evidence for CBT is poorer say experts

• Second, combining CBT with antidepressants should not be routine.
  
  

He suggests that doctors should try to adopt a more dimensional approach to depression rather than over-emphasising categories of disease severity such as “not depressed”, “clinical depression”, etc, or relying too heavily on cut-off points such as simply counting symptoms. It is important to consider an individual patient’s situation in a more rounded fashion such as past history, degree of impairment, duration of symptoms and risk of relapse.

“Overall, the guidelines clear up some issues and alter the emphasis on certain treatments for example suggesting that for subthreshold depression, which is not of clinical severity, antidepressants should be considered if it lasts more than 2-3 months,” Dr Anderson says. “We have also challenged the idea that antidepressants need to be given more than once a day or that for most antidepressants you need to follow a long tailing off before starting a new antidepressant.”

“We hope [the guidelines] will set a standard. We have tried to be practical in our advice and addressed issues that other guidelines tend not to be specific about such as managing side-effects of antidepressants. We want to help doctors and patients choose treatments and strategies that have the best chance of helping,” Dr Anderson concludes.

Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2000 British Association for Psychopharmacology guidelines is available on SAGE Journals Online at http://jop.sagepub.com/cgi/content/abstract/0269881107088441v2. The article will be free online for one month.

To arrange an interview with Dr Anderson regarding this article, contact Mithu Mukherjee: / Tel: +44 (0)20 7324 2223/ Mobile: +44 (0)7795 031 482

The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides an essential forum for researchers and practising clinicians on the effects of drugs on animal and human behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is published by SAGE, in Association with British Association for Psychopharmacology

SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology and medicine. An independent company, SAGE has principal offices in Los Angeles, London, New Delhi, and Singapore. www.sagepub.co.uk