[Rationalizing the prescription of antidepressants]

The prescription of antidepressant drugs should only concern depressed patients fulfilling diagnostic criteria for a major depressive episode. This prescription should remain as simple as possible and the association of other psychotropic drugs should not be systematic. Optimal doses should be reached rapidly but the therapeutic efficacy will only become obvious after 2-4 weeks and complete after 6-8 weeks. As most antidepressants display a similar therapeutic efficacy, the choice will depend on tolerability, patient characteristics and the result of previous therapeutic attempts. Prescribing an antidepressant requires a thorough supervision and repeated visits during the first weeks of treatment. The recommended duration of treatment for a depressive episode is six months and the medication should he tapered off progressively in order to avoid withdrawal symptoms.