Treatment Guidelines from The Medical Letter
Drugs for Depression and Bipolar Disorder
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Updated March 2012

Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.


Antidepressant drugs produce a response in about 50-60% of adults with major depression and a remission in about 30%; 80% of patients will eventually respond to drug therapy. Antidepressants may take 1-4 weeks to produce detectable improvement and often require 6-12 weeks to achieve substantial benefit. Depression with psychotic features requires addition of an antipsychotic drug to an antidepressant or treatment with ECT.

SSRIs — Selective serotonin reuptake inhibitors (SSRIs), with their generally tolerable ... more      

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