A brief review of antidepressant efficacy, effectiveness, indications, and usage for major depressive disorder.
OBJECTIVE
Antidepressants treat major depressive disorder (MDD) with the burden of associated side effects and difficulties with compliance. The purpose of this article is to review the efficacy and effectiveness of antidepressants for MDD.


METHODS
The authors conducted a focused review of selected key issues and references relevant to the clinically relevant pharmacologic treatment of MDD. Principles of treatment are reviewed. Antidepressants reviewed include SSRIs, mixed norepinephrine or serotonin uptake inhibitors, dopamine or norepinephrine uptake inhibitors, norepinephrine uptake inhibitors, antidepressants with mixed properties, and monoamine oxidase inhibitors. Augmentation and psychotherapy strategies are reviewed.


RESULTS
Antidepressant efficacy has been established in randomized clinical trials and effectiveness studies for acute and long-term treatment, but many patients do not achieve remission. Augmentation strategies and focused psychotherapy can be helpful.


CONCLUSIONS
Antidepressants help most patients with MDD but some are resistant to treatment and have a difficult long-term course.
Nierenberg
Andrew A
AA
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA. anierenberg@partners.org
Ostacher
Michael J
MJ
Huffman
Jeffrey C
JC
Ametrano
Rebecca M
RM
Fava
Maurizio
M
Perlis
Roy H
RH
D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D000928:Antidepressive Agents