Major depressive disorder: Validated treatments and future challenges
Summary & key facts
This review says major depressive disorder causes poor quality of life and trouble functioning. In the acute phase, treatment aims to reach remission and help people return to their usual level of functioning. Drug treatment is used most often, especially selective serotonin reuptake inhibitors (SSRIs). Depression-focused psychotherapy is the second most common choice. Electroconvulsive therapy (ECT) is the most effective somatic option in some specific cases. The paper says combining medicines, psychotherapy, and somatic treatments is the best approach for hard-to-treat depression, while other methods still need more study.
- Depression often leads to poor quality of life and impaired functioning.
- The main goal of acute-phase treatment is to reach remission and return the patient to their baseline level of functioning.
- Pharmacotherapy is the most frequent treatment during the acute phase, with selective serotonin reuptake inhibitors (SSRIs) being used especially often.
- Depression-focused psychotherapy is the second most common treatment to help in the acute phase, to keep remission, and to prevent relapse.
- Electroconvulsive therapy (ECT) is described as the most effective somatic (physical) therapy for depression in some specific situations.
- For treatment-resistant depression, combining medications, psychotherapy, and somatic therapies is reported as the most effective strategy, while other methods have limits and need more research.
Abstract
Depression is a prevalent psychiatric disorder that often leads to poor quality of life and impaired functioning. Treatment during the acute phase of a major depressive episode aims to help the patient reach a remission state and eventually return to their baseline level of functioning. Pharmacotherapy, especially selective serotonin reuptake inhibitors antidepressants, remains the most frequent option for treating depression during the acute phase, while other promising pharmacological options are still competing for the attention of practitioners. Depression-focused psychotherapy is the second most common option for helping patients overcome the acute phase, maintain remission, and prevent relapses. Electroconvulsive therapy is the most effective somatic therapy for depression in some specific situations; meanwhile, other methods have limits, and their specific indications are still being studied. Combining medications, psychotherapy, and somatic therapies remains the most effective way to manage resistant forms of depression.
