An evidence-based psychotherapy, such as cognitive behavioral therapy, is an appropriate treatment without an antidepressant for mild-to-moderate major depression. This is especially true in cases where the patient is suffering from significant psychosocial stress. While clinicians must accept the choice of a woman with severe depression who does not want to take medication, every effort should be made to overcome her resistance. An individual with both obsessive-compulsive disorder and depression is very likely to receive benefit from an antidepressant for both conditions. A patient who has failed adequate trials of 2 different SSRIs should be prescribed another class of antidepressant.
- A 45-year-old man with mild major depression and significant psychosocial stress.
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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