What is it about?
Treatment guidelines provide evidence-based recommendations for management of depression and other psychiatric disorders. However, many treatment guidelines for depression fail adequately to warn of potentially serious adverse effects associated with a class of medications called second-generation antipsychotics (SGAs), which are commonly recommended for patients insufficiently responsive to antidepressant treatment. This paper examines the guidance offered by the best quality depression treatment guidelines on monitoring for SGAs side effects and suggests ways to improve treatment guideline quality to enhance attention to drug adverse effects.
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Why is it important?
The paper calls attention to serious adverse effects of medications that are insufficiently emphasized both in treatment guidelines and clinical practice. It thus highlights problems with current treatment guideline development methodology and calls attention to an overlooked risk in current approaches to managing depression.
Perspectives
I hope that this article spurs re-examination of the place of antipsychotics in management of non-psychotic unipolar depression. More generally, I hope that the article might inform treatment guideline formulation such that drug adverse effects receive due consideration, particularly those emerging from long-term use and not captured in standard clinical trial results.
Harish Kavirajan
University of California, Irvine
Read the Original
This page is a summary of: Neglect of Adverse Effects in Treatment Guidelines for Depression, American Journal of Psychiatry, April 2024, American Psychiatric Association,
DOI: 10.1176/appi.ajp.20230553.
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