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Antidepressant therapy


In diagnosing depression, the most important maxim is to remember its existence. Depression may present overtly or covertly; it may be associated with suicide, alcoholism, or addiction to amphetamines. Perhaps half the depressions seen in general practice require specific treatment, of which a quarter may need referral to a psychiatrist or a psychiatric hospital. If left untreated about 1 in 7 severe depressives die, commit suicide, or become chronic invalids. About these observations there is general agreement. Unfortunately, views about treatment are more diverse, and it is impossible to discuss all of them in a short article, especially if the conclusions are to be firm enough for general use. What follows, therefore, does not represent a consensus of psychiatric opinion, for this does not exist. It is an account of a consistent approach to therapy well supported by experimental evidence and found useful in practice.

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