People with depression should make the choice on what treatment option is right for them, in discussion with their healthcare professional, NICE says in new draft guidance.
An independent NICE guideline committee has developed the first guideline for 12 years to identify, treat and manage depression in adults.
It has looked at the evidence on the treatment of new depressive episodes, chronic depression, preventing relapse, patient choice, and the organisation of, and access to, mental health services.
The committee has created a menu of treatment options to allow patients to pick the one which is right for them, in a shared decision-making discussion between them and their healthcare practitioner.
Patients with less severe depression could choose from the menu as a first-line treatment option from, for example, cognitive behavioural therapy (CBT), exercise, counselling or psychotherapy.
A similar range of psychological interventions, along with the option of antidepressant medication, is available to those choosing a first-line treatment for more severe depression.
... The COVID-19 pandemic has shown us the impact depression has had on the nation’s mental health. People with depression need these evidence-based guideline recommendations available to the NHS, without delay.
—Dr Paul Chrisp, director of the centre for guidelines at NICE
According to the Office of National Statistics, around one in six (17%) adults aged 16 years and over in Great Britain experienced some form of depression in summer 2021. The rate remains higher than those observed before the coronavirus pandemic (July 2019 to March 2020), where 10% of adults experienced some form of depression.
Nav Kapur, professor of psychiatry and population health at the University of Manchester and chair of the guideline committee, said: “This is a broad ranging guideline on depression which has been an enormous challenge to produce. As a committee we have drawn up recommendations that we hope will have a real impact on people who are suffering from depression and their carers.
“In particular we’ve emphasised the role of patient choice – suggesting that practitioners should offer people a choice of evidence-based treatments and understanding that not every treatment will suit every person. We now need stakeholders' help to make the recommendations as good as they can possibly be.”
There has been significant progress in science and medicine in the past 12 years.
This guideline emphasises a greater amount of patient choice and takes greater account of the things that really matter to the patients and their carers.
—Catherine Ruane, lay member on the guideline committee
who acted as a carer to two family members with depression
The guideline also contains new recommendations for those stopping antidepressant medication.
Public Health England’s 2019 evidence review, ‘Dependence and withdrawal associated with some prescribed medicines‘, showed 17% of the adult population in England (7.3 million people) had been prescribed antidepressants in the year 2017 to 2018.
People who are considering taking, or stopping, antidepressants medication should talk with their healthcare professional about the benefits and risks. The healthcare professional should explain that withdrawal may take weeks or months to complete successfully, that it is usually necessary to reduce the dose in stages over time and that most people stop antidepressants successfully.
Registered stakeholders can take part in the consultation until Wednesday 12th January 2022 at nice.org.uk.