For further detail regarding the non-pharmacological therapies, continued care in the community, or antidepressant adverse effects see the 'Depression Treatment in Primary Care' guideline available on NHSGGC StaffNet, search in 'CNS' section.
Read the following before continuing to the flowchart.
Make a positive diagnosis |
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If an antidepressant is indicated check whether recurrence of depression or new diagnosis |
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If effective, continue for at least 6 months following recovery. Review regularly, however this may vary with individual needs. |
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If no response after adequate trial (check concordance) or intolerable side effects:
If no response also review diagnosis. |
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If effective, continue for at least 6 months following recovery. Duration of treatment may vary depending on the severity of condition, see the 'Depression Treatment in Primary Care' guideline available on NHSGGC StaffNet for further detail. |
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If no response after adequate trial, or intolerable side effects:
Notes: *Duloxetine: Psychiatrist initiation only. **Venlafaxine: Regular monitoring of BP as clinically appropriate. Prescribe the standard release preparation instead of the MR/XL preparations. Psychiatric supervision required for patients of daily doses of venlafaxine 300 mg and above and on initiation of a severely depressed patient. |
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If effective, continue for at least 6 months following recovery |