The treatment of depression in an ambulatory care setting

Nurse practitioners in a primary care setting often see patients suffering from depression. Many of these patients can be treated in the primary care setting by the nurse practitioner, in collaboration with a psychiatric clinical nurse specialist. Treatment modalities that can be effectively used for depressed patients in this setting include brief individual or group psychotherapy using short-term therapy models such as cognitive or interpersonal therapy, and/or antidepressant medications. Basic concepts and intervention techniques for the cognitive and interpersonal therapy models are described. Tricyclic antidepressants are highlighted including tables and content on action, target symptom side effects, drug-drug interactions, dosage schedules and patient education. In addition, other medications for depression such as lithium, monoamine oxidase inhibitors and psychostimulants are briefly reviewed.