Depression: a review of acute pharmacological treatment

The author discusses adequate pharmacological treatment for depression. The discussion is based on data from psychopharmacological research, from recommendations given in manuals of psychopharmacology, and from surveys of psychopharmacological practices of affective disorders clinics. The review is limited to the treatment of major depressive episodes with or without melancholia. The treatment of atypical and psychotic depressions is discussed elsewhere. The review is also limited to treatment with non-monoamine oxidase inhibitors antidepressants. The paper is divided in three parts: optimization of treatment; remission rates achieved by optimization of treatment; and lack of optimization of treatment in every day practice and research.