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Pharmacological management of unipolar depression

Malhi, G. S., Hitching, R., Berk, M., Boyce, P., Porter, R. and Fritz, K. 2013, Pharmacological management of unipolar depression, Acta psychiatrica scandinavica, vol. 127, no. Supplement s443, pp. 6-23, doi: 10.1111/acps.12122.

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Title Pharmacological management of unipolar depression
Author(s) Malhi, G. S.
Hitching, R.
Berk, M.ORCID iD for Berk, M. orcid.org/0000-0002-5554-6946
Boyce, P.
Porter, R.
Fritz, K.
Journal name Acta psychiatrica scandinavica
Volume number 127
Issue number Supplement s443
Start page 6
End page 23
Total pages 18
Publisher Wiley-Blackwell Publishing
Place of publication Malden, Mass.
Publication date 2013-05
ISSN 0001-690X
1600-0447
Keyword(s) major depressive disorder
antidepressants
treatment algorithm
clinical practice guidelines
recommendations
Summary Objective : To be used in conjunction with ‘Psychological management of unipolar depression’ [Lampe et al. Acta Psychiatr Scand 2013;127(Suppl. 443):24–37] and ‘Lifestyle management of unipolar depression’ [Berk et al. Acta Psychiatr Scand 2013;127(Suppl. 443):38–54]. To provide clinically relevant recommendations for the use of pharmacological treatments in depression derived from a literature review.

Method :
Using our previous Clinical Practice Guidelines [Malhi et al. Clinical practice recommendations for bipolar disorder. Acta Psychiatr Scand 2009;119(Suppl. 439):27–46] as a foundation, these clinician guidelines target key practical considerations when prescribing pharmacotherapy. A comprehensive review of the literature was conducted using electronic database searches (PubMed, MEDLINE), and the findings have been synthesized and integrated alongside clinical experience.

Results : The pharmacotherapy of depression is an iterative process that often results in partial and non-response. Beyond the initiation of antidepressants, the options within widely used strategies, such as combining agents and switching between agents, are difficult to proscribe because of the paucity of pertinent research. However, there is some evidence for second-line strategies, and a non-prescriptive algorithm can be derived that is based broadly on principles rather than specific steps.

Conclusion : Depression is by its very nature a heterogeneous illness that is consequently difficult to treat. Invariably, situation-specific factors often play a significant role and must be considered, especially in the case of partial and non-response. Consulting with colleagues and trialling alternate treatment paradigms are essential strategies in the management of depression.
Language eng
DOI 10.1111/acps.12122
Field of Research 110999 Neurosciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30052819

Document type: Journal Article
Collections: School of Medicine
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Created: Tue, 04 Jun 2013, 13:49:36 EST by Jane Moschetti

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.