Concise guidelines: Use of antidepressant medication in adults

Use of antidepressant medication in adults undergoing recovery and rehabilitation following acquired brain injury

National guidelines

Summary

Depression is increasingly recognised as a common sequel to brain injury and the use of antidepressant medication in this context has increased markedly over recent years. However, these drugs are not without side effects - some of them serious - and they should not be used without proper evaluation and monitoring, to guide clinicians working with people who have brain injury of any cause (ie stroke, trauma, anoxia, infection etc).

The guidance covers

• screening and assessment of depression in the context of brain injury
• issues to consider and discuss with the patient and family/carer before starting treatment, and
• proper treatment planning and evaluation - including planned withdrawal at the end of the treatment

Also included are assessment tools, a checklist for management of depression following acquired brain injury and specially written information for patients and their families and carers.

Contents

• Introduction
• Background
• The approach for these guidelines
• Diagnosis and management of depression
• Capacity and consent
• The evidence for the use of antidepressants in people with ABI
• The guidelines
• Differences between antidepressants
• Implications for implementation
• Appendices

1 - Guideline development process
2 - Screening and assessment of depression in ABI
3 - Assessment tools and where to find them
4 - Checklist for the management of depression following ABI
5 - Information for patients, families and carers: Depression after brain injury

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