Guidelines for the Pharmacotherapy of Major Depressive Disorder

I have summarised the following recommendations from the Maudsley prescribing guidelines in Psychiatry, 13th Ed.

Psychotherapies

Supportive psychotherapy, CBT, interpersonal therapy, marital/couple therapy, dynamic psychotherapy, behavioral activation

Depressive episode

Step-1

SRI/ Mirtazapine

à A generic SRI; use mirtazapine if sleep needed

Step-2

SSRI/non-SRI

  à Most evidence is for a switch to vortioxetine

Step 3

Mirtazapine, vortioxetine, agomelatine

 à if not already trialed

Taylor DM, Barnes TR, Young AH. The Maudsley prescribing guidelines in psychiatry. 13th ed. John Wiley & Sons; 2018:823.