American College of Physicians guidelines for the treatment of acute depression in adults

Question clinique

What are the updated guidelines from the American College of Physicians for the treatment of acute depression?


For patients in the acute phase of major depressive disorder, the ACP continues the trend away from drug therapy and toward talk therapy. CBT is recommended as first-line treatment for patients with moderate symptoms (conditional recommendation). Citing evidence that up to 70% of patients with moderate to severe depression will not respond to a second-generation antidepressant, the group recommends offering CBT, medication therapy, or the combination of both to patients with more profound symptoms. (LOE = 5)

Overuse alert: This POEM aligns with the Canadian Psychiatric Association’s Choosing Wisely Canada recommendation: Don’t routinely use antidepressants as first-line treatment for mild or subsyndromal depressive symptoms in adults.

Plan de l'etude: Practice guideline

Financement: Foundation

Cadre: Various (guideline)


Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA

Discutez de ce POEM


Rachel Park


The problem if finding affordable timely CBT


Impact assessment




le plus gros problème est d'avoir accès à la thérapie cognitivo-comportementale, ce qui explique probablement pourquoi tant d'antidépresseurs sont utilisés même pour traiter la dépression d'intensité légère