Patients with depression should be allowed to pick from a menu of treatment options as part of shared decision-making between them and their healthcare practitioner, according to new draft NICE guidance.

The new guidance looks 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.

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Dr Paul Chrisp, director of the centre for guidelines at NICE, said: “People with depression deserve and expect the best treatment from the NHS which is why this guideline is urgently required.

“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.”

One in six adults experienced some form of depression during pandemic

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.

Patients can choose a range of psychological interventions from the menu such as cognitive behavioural therapy (CBT), exercise, counselling or psychotherapy. The option of antidepressant medication is available to those with more severe 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. 

“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.” 

The guideline also contains new recommendations for those stopping antidepressant medication. 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 (called ‘tapering’) and that most people stop antidepressants successfully.

Registered stakeholders can take part in the consultation until Wednesday 12th January 2022 at nice.org.uk

For more new and articles on depression go to our psychiatry section