Do General Practitioners Follow Guidelines on the Use of Antidepressants To Treat Depression? Can the Situation Be Improved?

Several papers have been written to show that General Practitioners do not always prescribe according to the guidelines despite the availability of guidelines regarding the dosage and length of treatment with antidepressants to treat a depressive episode. Here we review the evidence as to whether GPs follow antidepressant guidelines, covering the data between 1996 and the present day, and discuss the implications of this evidence. We then propose solutions which could be used to improve adherence to the guidelines. We propose as one solution the development of joint Doctor-Practice Nurse clinics for the treatment of depression. The outcomes of these clinics should be auditable against the guidelines. Such a solution, when linked with easy access to advice and referral to Secondary Care Psychiatry specialists, argues for a collaborative care or shared care program for the treatment of depression in Primary Care.