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

Clinical Question

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

Bottom line

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.

Study design: Practice guideline

Funding: Foundation

Setting: Various (guideline)

Reviewer

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


Discuss this POEM


Comments

Rachel Park

Depression

The problem if finding affordable timely CBT

ARUP KUMAR DHARA

Impact assessment

Excellent

Anonymous

dépression

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