Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines

Anthony Cleare; C M Pariante; A H Young; I M Anderson; D Christmas; P J Cowen; C Dickens; I N Ferrier; J Geddes; S Gilbody; P M Haddad; C Katona; G Lewis; A Malizia; R H McAllister-Williams; P Ramchandani; J Scott; D Taylor; R Uher; Members of the Consensus Meeting

doi:10.1177/0269881115581093

Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines

J Psychopharmacol. 2015 May;29(5):459-525. doi: 10.1177/0269881115581093. Epub 2015 May 12.

Authors

Anthony Cleare¹, C M Pariante², A H Young³, I M Anderson⁴, D Christmas⁵, P J Cowen⁶, C Dickens⁷, I N Ferrier⁸, J Geddes⁹, S Gilbody¹⁰, P M Haddad¹¹, C Katona¹², G Lewis¹², A Malizia¹³, R H McAllister-Williams¹⁴, P Ramchandani¹⁵, J Scott¹⁶, D Taylor¹⁷, R Uher¹⁸; Members of the Consensus Meeting

Affiliations

¹ Professor of Psychopharmacology & Affective Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK anthony.cleare@kcl.ac.uk.
² Professor of Biological Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK.
³ Professor of Psychiatry and Chair of Mood Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK.
⁴ Professor and Honorary Consultant Psychiatrist, University of Manchester Department of Psychiatry, University of Manchester, Manchester, UK.
⁵ Consultant Psychiatrist, Advanced Interventions Service, Ninewells Hospital & Medical School, Dundee, UK.
⁶ Professor of Psychopharmacology, Psychopharmacology Research Unit, Neurosciences Building, University Department of Psychiatry, Warneford Hospital, Oxford, UK.
⁷ Professor of Psychological Medicine, University of Exeter Medical School and Devon Partnership Trust, Exeter, UK.
⁸ Professor of Psychiatry, Honorary Consultant Psychiatrist, School of Neurology, Neurobiology & Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
⁹ Head, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
¹⁰ Director of the Mental Health and Addictions Research Group (MHARG), The Hull York Medical School, Department of Health Sciences, University of York, York, UK.
¹¹ Consultant Psychiatrist, Cromwell House, Greater Manchester West Mental Health NHS Foundation Trust, Salford, UK.
¹² Division of Psychiatry, University College London, London, UK.
¹³ Consultant in Neuropsychopharmacology and Neuromodulation, North Bristol NHS Trust, Rosa Burden Centre, Southmead Hospital, Bristol, UK.
¹⁴ Reader in Clinical Psychopharmacology, Institute of Neuroscience, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
¹⁵ Reader in Child and Adolescent Psychiatry, Centre for Mental Health, Imperial College London, London, UK.
¹⁶ Professor of Psychological Medicine, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
¹⁷ Professor of Psychopharmacology, King's College London, London, UK.
¹⁸ Associate Professor, Canada Research Chair in Early Interventions, Dalhousie University, Department of Psychiatry, Halifax, NS, Canada.

PMID: 25969470
DOI: 10.1177/0269881115581093

Abstract

A revision of the 2008 British Association for Psychopharmacology evidence-based guidelines for treating depressive disorders with antidepressants was undertaken in order to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in September 2012. Key areas in treating depression were reviewed and the strength of evidence and clinical implications were considered. The guidelines were then revised after extensive feedback from participants and interested parties. A literature review is provided which identifies the quality of evidence upon which the recommendations are made. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse and stopping treatment. Significant changes since the last guidelines were published in 2008 include the availability of new antidepressant treatment options, improved evidence supporting certain augmentation strategies (drug and non-drug), management of potential long-term side effects, updated guidance for prescribing in elderly and adolescent populations and updated guidance for optimal prescribing. Suggestions for future research priorities are also made.

Keywords: Antidepressants; depression; depressive disorder; evidence-based guidelines; treatment.

Publication types

Practice Guideline

MeSH terms

Antidepressive Agents / therapeutic use*
Combined Modality Therapy
Consensus
Depressive Disorder / drug therapy*
Evidence-Based Medicine
Humans
Secondary Prevention

Substances

Antidepressive Agents

Grants and funding

G108/603/MRC_/Medical Research Council/United Kingdom