Major Depressive Disorder
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Complications and Prognosis
Screening and Prevention
Recommended initial treatment options for patients with moderate to severe major depressive disorder: r4
Recommended initial treatment for patients with mild major depressive disorder is cognitive behavioral therapy r4
Initial treatment with a combination of pharmacotherapy and psychotherapy is recommended for patients with any of the following: r5r13r25r26
The following second generation antidepressants are the first line options for pharmacotherapy: start treatment at low dose and gradually increase to approved maximum dose r4r5r25r27
For patients with an inadequate response to an adequate trial of initial pharmacotherapy (ie, one of the above agents at maximum dose for at least 4 to 6 weeks), options include: r5r25
Offer repetitive transcranial magnetic stimulation to patients with inadequate response to two or more adequate trials of medication r25
Consider electroconvulsive therapy for patients with any of the following: r5r25
Relapse prevention r26
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