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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Non-Drug Therapies for Depression

The National Prescribing Centre has published a MeReC Bulletin that reviews Non-Drug Therapies for Depression in Primary Care.

The review is based on the NICE Guideline for Depression but summarises the following recommendations:

  • There is little evidence of different efficacy between non-drug interventions. Choice should be based on patient preference and past experience, and local availability.
  • For most people with mild depression general advice including exercise and watchful waiting may be sufficient. Guided self help based on cognitive based therapy (CBT) or short-term psychological therapies (counselling, problem solving and brief CBT) may be considered for those requiring treatment. Antidepressants are not recommended initially for mild depression.
  • More extensive psychological therapies (16-20 sessions over 6-9 months) such as CBT or interpersonal therapy are appropriate for patients with moderate depression who do not respond to, or prefer not to take, antidepressants. They should be used with antidepressants in severe depression.

Action: Clinicians who diagnose and treat any form of depression should be aware of the place of non-drug therapies in treatment. Clinicians should also be aware of the services they are able to access at local level.

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