American Psychiatric Association Practice Guidelines. Agency for Health Care Policy and Research. Depression in primary care. Clinical Practice Guidelines No. 5. Patients with moderate to severe major depressive disorder are appropriately treated with medication , whether or not formal psychotherapy is also used.
Medication is administered in dosages shown to alleviate symptoms.
The specific medication of choice is based on side effect profiles, history of prior response, family history of response, type of depression, concurrent general medical or psychiatric illnesses, and concurrently prescribed medication. These are expert statements of good practice supported by evidence within the reviews. Switching to a new medication is an option after an adequate trial of a first treatment. A general medical principle is that two drugs should not be combined where one is sufficient. Switching to a new medication is often preferred to augmentation of the first medication as an initial strategy.