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Cited by 132Treatment of Major DepressionMental Health Treatment and AccessPsychotherapy Techniques and Applications

Evidence review: efficacy and effectiveness of antidepressant treatment in primary care

Simon, Gregory E·2002·General Hospital Psychiatry
DOI 10.1016/s0163-8343(02)00198-6
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Abstract

This review considers evidence for the efficacy of pharmacotherapy among primary care patients with depressive disorders and reviews knowledge regarding the effectiveness of current practice. Strong evidence supports the efficacy of antidepressant pharmacotherapy for primary care patients with major depression and dysthymia with some evidence for pharmacotherapy of less severe depression. In general, available antidepressants appear equal in both efficacy and effectiveness. Treatment selection for any individual patient remains largely empirical, with few clinical characteristics predicting better or worse response to specific treatments. Strong evidence supports continuation treatment (i.e., at least six months of pharmacotherapy) for all patients and maintenance treatment (i.e., at least 24 months of pharmacotherapy) for those with chronic or recurrent depression. Unfortunately, few patients in primary care or specialty practice receive recommended levels of pharmacotherapy or recommended frequency of follow-up care. A number of recent studies have evaluated strategies to improve the quality of antidepressant treatment in primary care. Educational programs (including academic detailing and continuous quality improvement) have had little impact on patient outcomes. Key elements of effective care improvement programs include specific, evidence-based treatment protocols, organized patient education and active follow-up care.

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Crossref · 10.1016/s0163-8343(02)00198-6

Cites

121 of 121 references verified0 citation errors · 0 not checkable

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  • Only one half of patients with major depression receive an accurate diagnosis in primary care, and of those with a diagnosis, only one third to one half receive appropriate pharmacotherapy or psychotherapy.

    “Only one half of patients with major depression receive an accurate diagnosis in primary care and, of those with a diagnosis of major depression, only one third to one half receive appropriate pharmacotherapy or psychotherapy.84”

    From Anxiety and Depression in COPD (2008) · cites this paper as [84]

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Authors
Simon, G. E.
Affiliations
Group Health Cooperative (US)
Corresponding author
Simon, Gregory E
ORCID
Simon, Gregory E
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2002-07
Volume
24
Issue
4
Pages
213-224
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/s0163-8343(02)00198-6
OpenAlex
W2056142446
Cited by
132
References
124
Citations by year
2025: 2 · 2024: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 6 · 2014: 5 · 2013: 11 · 2012: 7
FWCI
0.76
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH051338, MH51338)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
antidepressants, antidepressant treatment, major depressive disorder, dysthymia, primary care, treatment efficacy, treatment effectiveness, continuation treatment, maintenance therapy, follow-up care, educational programs, academic detailing, continuous quality improvement, treatment protocols, patient education
MeSH terms
Antidepressive Agents, Depressive Disorder, Humans, Mental Health Services, Primary Health Care

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