NICE has recommended the use of antidepressants to treat patients with moderate or severe depression, or for those with mild symptoms when other interventions have not been successful.
However, the Institute has urged against the routine use of antidepressants to treat patients with only mild symptoms.
These recommendations form part of updated guidance, produced for NICE by the National Collaborating Centre for Mental Health, on the identification, treatment and management of depression in adults in both primary and secondary care.
The guidance states that drug treatment should be considered for patients with a past history of moderate or severe depression, for those with sub-threshold depressive symptoms that have been present for at least 2 years, or for patients with mild depression that persists after other interventions.
For those with mild symptoms, the guidelines recommend initial treatment with either individual guided self-help based on the principles of cognitive behavioural therapy (CBT), computerised cognitive behavioural therapy (CCBT) or a structured group physical activity programme.
For the treatment of moderate or severe depression, NICE encourages a combination of antidepressant medication and a high-intensity psychological intervention such as CBT.
The guidance also adds that patients who have benefited from antidepressant treatment should be supported to continue treatment for at least six months after symptoms have improved, to reduce the risk of relapse.
Professor Ian Anderson, Professor of Psychiatry, University of Manchester and Chair of the Guidance Development Group (GDG), said: “The treatment of depression can be difficult. Everyone who has depression has their own story and their treatment needs to be individually tailored for them.
“These guidelines offer choice and will support doctors and those with depression to find the best treatment for them. Good communication between doctors and their patients is essential and the decision as to which treatments to use should be a decision made in partnership.”