Antidepressants are the first-line treatment for depression, but the first round of antidepressant treatment for many patients is not smooth. For example, the early side effects cannot be tolerated or the effect is not as expected, and treatment needs to be adjusted. However, there is no consensus on when to adjust and how to adjust.

In an article published in Aust NZJ Psychiatry., Bernhard T Baune of the University of Münster in Germany and Peter Falkai of the University of Munich discussed the key time points of antidepressant treatment decisions through a review of the literature, and gave antidepressant treatments The concise decision diagram:

The author points out that there is sufficient evidence to show that depression patients who have good early effects are more likely to continue to be clinically cured in the future. In fact, the earlier evaluation of the early efficacy of antidepressants is also the revision direction of some authoritative guidelines, including the CANMAT guidelines.

The author’s core point is that if the patient does not feel any benefit from the antidepressant after 2 weeks of treatment, the doctor should consider the need to replace the antidepressant.

Literature Index:

Baune BT, Falkai P. Changes in antidepressant therapy should be considered early in patients with inadequate response to a first-line agent. Aust N Z J Psychiatry. 2020 Oct 28:4867420968912. doi: 10.1177/0004867420968912. Epub ahead of print. PMID: 33111538.