Antidepressants
Psychiatrymedium
A 35-year-old man is diagnosed with major depressive disorder and started on an SSRI. Which statement best reflects appropriate initial management and follow-up?
- A.Start one SSRI and reassess in about 2 weeks, checking tolerability first and response over the following weeksCorrect
- B.Start two antidepressants together to achieve a faster response
- C.Expect full remission within 3 days of starting the drug
- D.Avoid any follow-up until at least 3 months have passed
Explanation
Depression is treated by initiating a single first-line antidepressant and reassessing at around 2 weeks, first for side effects and tolerability, then over the following 3 to 4 weeks for therapeutic response. If the effect is weak the dose is increased, and if there is no effect the medication is changed.
Why each option
- A.
- Correct, start one agent and reassess at about 2 weeks for tolerability, then judge response over subsequent weeks.
- B.
- Combining two antidepressants at initiation is not standard first-line practice.
- C.
- Antidepressants take several weeks to work; remission in 3 days is not expected.
- D.
- Early follow-up is needed to check tolerability and emerging response, not a 3-month delay.
Reference: The Maudsley Prescribing Guidelines in Psychiatry, 13th ed.
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