title: [The algorithm for the biological treatment of depression in the Dutch multidisciplinary guideline on depression].
abstract: BACKGROUND
  Although antidepressants are effective in the treatment of depression, nonresponse is unfortunately a recurring problem. Treatment algorithms can help the health care professional to make consecutive step-by-step choices between the different available treatment options.
  
  
  OBJECTIVE
  To update the biological algorithm in the Dutch multidisciplinary guideline on the treatment of depression.
  
  
  METHODS
  The literature was reviewed systematically.
  
  
  RESULTS
  There are five steps in the algorithm: 1. Treatment starts with an SSRI, a TCA, an SNRI, mirtazapine or buproprion. 2. If there is no response after 4-10 weeks, administer another antidepressant. 3. Augment medication with lithium. 4. Administer a monoamine oxidase inhibitor. 5. Apply electroconvulsive therapy.
  
  
  CONCLUSIONS
  The algorithm is certainly worth using, but its efficacy needs to be fully investigated.s.
authors.affiliation: Trimbosinstituut, Utrecht. JSpijker@trimbos.nl
authors.forename: J
authors.initials: J
authors.lastname: Spijker
authors.forename: W A
authors.initials: WA
authors.lastname: Nolen
mesh_terms: D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000628:therapy*; D004565:Electroconvulsive Therapy; D006801:Humans; D033183:Interdisciplinary Communication; D017410:Practice Guidelines as Topic / Q000592:standards*; D011570:Psychiatry / Q000592:standards; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents