How to counsel patients about depression and its treatment

To provide effective counseling for patients receiving drug therapy for depression, one must understand the natural course of mood disorders, the appropriate dose and duration of antidepressant therapy, and how to individualize the discussion of potential adverse effects and use of alcohol. Patients must understand that effective antidepressant treatment requires several weeks before onset of clinical effect, and 6-12 months of therapy is necessary to prevent relapse. Discussion of adverse effects must address what the patient should do if an adverse effect occurs, with the focus on common, expectable effects of the particular drug. Rather than merely telling patients not to drink alcohol, appropriate counseling should focus on the possible consequences of drinking while taking antidepressant drugs.