People suffering from less severe depression should be offered a range of options before being given anti-depressants, doctors in the UK have been told.
The new guidance, which is subject to consultation, told doctors treating mild depression not to “routinely offer anti-depressants as a first-line treatment, unless that is the person’s preference.”
In a diagram of 11 options that doctors are expected to go through with patients who do not have a preference, anti-depressants came in at ninth place.
Group cognitive behavioural therapy (CBT), which focuses on how thoughts, beliefs, attitudes, feelings, and behaviour interact, could be offered as a first treatment, doctors were told.
Another intervention suggested by NICE’s guidelines committee was group behavioural activation (BA), which helps the person to recognise negative patterns and focus on behaviours that are linked to improved mood.
Individual BA or CBT may also be offered alongside group mindfulness or meditation, group exercise, and counselling.
But if the patient has a clear preference or experience from previous treatment, doctors are told to support the person’s decision unless they are concerned the preferred treatment doesn’t suit the episode.
When prescribing medication, to treat depression, doctors will need to explain the reasons for offering medication, and discuss with the patient the expected benefits as well as the possible side effects and withdrawal effects.
The guidance also made recommendations on how to help people successfully stop taking anti-depressant medication.
Figures from the NHS Business Services Authority show that more than 20 million anti-depressants were prescribed between October and December 2020—a 6 percent increase compared with the same three months in 2019.
The use of antidepressants has been steadily increasing since 2015.
