The prescription of antidepressants in general practice: I a critical review

This review critically examines the literature which is available on the way in which general practitioners use antidepressants, the kind of depressed patients who they choose to treat, and the trials of antidepressants which have specifically been carried out in general practice. General practitioners tend to use a ‘low-dose strategy’ of prescribing tricylics (75 mgs or less per day), which are the most commonly used antidepressants. While this is a subtherapeutic dose in psychiatric hospital patients there is evidence that GP's patients are less serverely depressed, and the low-dose strategy might be effective in such cases. A review of trials in general practice revealed only one study capable of addressing this question, which suggested a lack of efficacy of the low-dose strategy.