The use of antidepressants in a psychiatric emergency department

This article is the result of a pilot program at Sinai Hospital of Detroit's psychiatric emergency department (crisis clinic). Eight patients diagnosed as having a major depression and having met six proposed criteria were placed on antidepressant therapy. This approach contradicts traditional thinking regarding the initiation of antidepressant therapy in an emergency department or crisis clinic. Such use of antidepressants has, in the past, been considered unsafe and therefore contraindicated. This article suggests a protocol for the initiation of antidepressant therapy in an emergency department.