Am Fam Physician. 2025;112(4):458-461
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Supervised low- to moderate-intensity exercise for 30 to 40 minutes three to four times per week for a minimum of 9 weeks is a first-line monotherapy for mild depression.
• For most patients, psychotherapy should include 12 to 16 sessions twice weekly for best results.
• Bupropion, escitalopram, mirtazapine, paroxetine, sertraline, and extended-release venlafaxine are the most effective medications for treatment of major depressive disorder.
• Without an early improvement of 20% symptom reduction or more by 4 weeks of pharmacotherapy, there is a low likelihood of treatment response or remission at 8 to 12 weeks. The antidepressant medication should be switched or the dose increased in these patients.
From the AFP Editors
Although major depressive disorder is common and has significant effects on quality of life, only an estimated 20% of patients with the disorder receive adequate treatment. The Canadian Network for Mood and Anxiety Treatments (CANMAT) has published updated guidelines on management of major depressive disorder in adults.
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