When Is Pharmacotherapy Initiation Beneficial in Patients With Depressive Disorders?

Psychotherapy and pharmacotherapy are the most common treatments utilized in patients diagnosed with depressive disorders. Their efficacy in remitting symptoms and restoring patients to baseline functioning has been established throughout the literature; however, questions still remain on whether pharmacotherapy is necessary in all patients and if used, when initiation is most beneficial. Current guidelines recommend initiating only psychotherapy in patients with mild depression and advancing to pharmacotherapy as appropriate. Evidence-based literature has shown pharmacotherapy to have a significant and independent treatment effect in depressive disorders compared with psychotherapy. Combination treatment with both modalities has also shown to be beneficial for remitting depressive symptoms in this patient population. Therefore, treatment should be individualized for each specific patient based on severity of disease, history of depression and response to treatment, cost of treatment, and patient preference.