Antidepressant Treatment in Primary Care Systems

Primary care serves as the cornerstone for the identification and management of depressive disorders, offering accessible first‐line interventions that range from pharmacological treatment to psychosocial support. General practitioners typically initiate antidepressant therapy, most often prescribing selective serotonin reuptake inhibitors (SSRIs) owing to their favourable side‐effect profile and broad efficacy across depressive severities. Treatment decisions are guided by clinical assessment, patient preference and comorbidity considerations, with regular review to balance benefits against potential risks such as adverse events or long‐term dependency. Recent emphasis on stepped‐care models has highlighted the importance of tailoring duration and dose, integrating digital monitoring tools and facilitating collaborative care with mental health specialists. Global trends reveal rising prescribing rates, prolonged treatment courses and variable adherence to deprescribing guidelines, underlining the need for proactive medication reviews and decision‐support systems. Equity in access remains a priority, as sociodemographic factors and healthcare infrastructure shape prescribing patterns and outcomes. Ongoing research seeks to refine optimisation strategies that enhance remission rates while minimising unnecessary long‐term use.

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Antidepressant Treatment in Primary Care Systems publication trend

The graph below shows the total number of articles in antidepressant treatment in primary care systems across all publications each year (not limited to Nature Index journals).

Technical terms

Deprescribing: A planned process for reducing or stopping medicines that may no longer be beneficial or may be causing harm.

Acceptability: The proportion of patients who continue treatment over a defined period, reflecting willingness to remain on therapy.

Tolerability: The extent to which adverse effects allow patients to persist with a medication.

Remission: A state in which depressive symptoms fall below a threshold that meets diagnostic criteria.

Selective serotonin reuptake inhibitor (SSRI): A class of antidepressant that enhances serotonin availability by inhibiting its reabsorption into nerve cells.

References

1. Deprescribing of antidepressants: development of indicators of high-risk and overprescribing using the RAND/UCLA Appropriateness Method. BMC Medicine (2024).
2. Real-world effects of antidepressants for depressive disorder in primary care: population-based cohort study. The British Journal of Psychiatry (2024).
3. Do sociodemographic and clinical factors affect the selection of initial antidepressant treatment for depression in older adults? Results from a nationwide descriptive study in Denmark. Journal of Affective Disorders (2023).