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Venlafaxine 37.5 dosage forms were approved for use in clinical trials Australia. The efficacy of these medications has since been established primarily in patients with major depression. While evidence supporting the efficacy of fluoxetine is based on clinical trials, experience suggests potential benefits of paroxetine and mirtazapine in patients with major depression. Although all three drugs have been approved and used in clinical trials, there are limited data and no evidence currently to justify the clinical development of any them in the treatment of depression. light limited evidence, there is insufficient information available to support the proposed clinical development of new antidepressant drugs with qualities in patients major depression. What are the key considerations for treatment of depressed patients? In the absence of new effective treatments and with insufficient evidence to support a new antidepressant in the treatment of major depression, Panel judged that treatment of depression in clinical practice should be based on pharmacotherapy (which may include antidepressant medication) in combination with other pharmacological and non-pharmacological treatments. There is insufficient evidence to determine the optimal combination of treatments for depression. When treatment is implemented in a clinical trial it is likely that the treatment strategy employed in that trial will be followed. The Panel considers that patients' response to treatment will be predictable and that the benefits of treatment depressed patients will be consistent between patients. What are the key considerations for treatment decision-making? Clinically necessary treatment is generally considered to include pharmacotherapy alone, although for patients with mild to moderate depression treatment may include non-pharmacotherapy such as cognitive behaviour therapy. venlafaxine cost uk Patients should receive antidepressant medication in appropriate dose (eg, 15 mg/day, 50 and lower doses). As a general guideline, dose of 3 or 4 mg/day the standard recommended drug and one of the following combinations antidepressants should be considered. The decision to use these combinations and doses is informed by clinical needs. The decision about use of different antidepressants should be guided by factors such as the individual's response to treatment, personal preference and the overall pharmacological treatment strategy of the patient. There are no pre-specified pharmacological thresholds, however, low doses of antidepressant medications may be useful after several months or at a slightly earlier stage in treatment. Medication combinations should be used as a first line treatment rather than as a first and last line treatment. The Panel believes that most depressed patients will have some benefit from initial antidepressant medication even in the absence of an adequate pharmacotherapeutic response, therefore, it is appropriate to provide treatment with antidepressant medication regardless of the response to previous treatment. benefits of treatment with different drugs may be greater over time if one drug is discontinued before achieving the desired clinical response, although there are indications that discontinuation of antidepressants prior to the anticipated time of a clinical response may cause an early relapse. In view of the limited evidence for antidepressant efficacy in severe depression, the Panel considers that there is insufficient evidence to recommend new antidepressants with antidepressant virtues to treat severe depression in patients currently receiving standard treatments. In addition, there is insufficient evidence to support therapeutic combinations that may result in a more rapid response than that observed from the combined treatment strategy of standard alone. There is no consensus as to when pharmacotherapy alone should be used for mild to moderate depression. As a general guideline, antidepressant response typically develops between three to six weeks from initiation of treatment. Do the following recommendations need to be interpreted with regard other conditions? All patients with depressive disorders need to be treated with non-pharmacological therapy such as support or cognitive behaviour therapy. The Panel considers that patients with depressive disorders have a strong desire and capacity to change, that cognitive behaviour therapy is an effective and accessible way to achieve this. Psychometric assessment of patients with depressive disorders is of importance in this regard. Psychotherapy may involve short sessions or prolonged therapy sessions, although brief counselling, however brief, may be effective in helping patients understand these feelings and to develop strategies cope with them. What are the benefits of cognitive behavioural therapy? Cognitive behavioural therapy (CBT) is a psychotherapeutic technique that uses structured, individualised psychodynamic and cognitive techniques to treat patients who have depression and are struggling with its impact on their daily functioning. CBT aims to manage depression through changes attitudes, values and beliefs, self-understanding of problems. The clinical approach aims to reduce depressive symptoms by identifying.

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