Guidance
Recommendations for research
Recommendations for research
The guideline committee has made the following recommendations for research.
Key recommendations for research
1 Stopping antidepressants
What is the incidence and severity of withdrawal symptoms for antidepressant medication?
For a short explanation of why the committee made the recommendation for research, see the rationale section on starting and stopping antidepressants.
For full details of the evidence and the committee's discussion, see the evidence reviews for the NICE guideline on safe prescribing (evidence review A: patient information and support; evidence review B: prescribing strategies; evidence review C: safe withdrawal; evidence review D: withdrawal interventions; evidence review E: monitoring).
Full details of the research recommendation have been added to evidence review B: treatment of a new episode of depression.
2 Relapse prevention
What is the effectiveness and cost effectiveness of brief courses of psychological treatment in preventing relapse for people who have had a successful course of treatment with antidepressants or psychological therapies but remain at high risk of relapse?
For a short explanation of why the committee made the recommendation for research, see the rationale section on preventing relapse.
Full details of the evidence and the committee's discussion are in evidence review C: preventing relapse.
3 Further-line treatment
What are the relative benefits and harms of further-line psychological, psychosocial, pharmacological and physical treatments (alone or in combination), for adults with depression showing an inadequate response to an initial psychological treatment for the current episode?
For a short explanation of why the committee made the recommendation for research, see the rationale section on further-line treatment.
Full details of the evidence and the committee's discussion are in evidence review D: further-line treatment.
4 Chronic depression
Are psychological, pharmacological or a combination of these treatments effective and cost effective for the treatment of older adults with chronic depressive symptoms?
For a short explanation of why the committee made the recommendation for research, see the rationale section on chronic depressive symptoms.
Full details of the evidence and the committee's discussion are in evidence review E: chronic depression.
5 Access
What are the most effective and cost-effective methods to promote increased access to, and uptake of, treatments for people with depression who are under-served and under-represented in current services?
For a short explanation of why the committee made the recommendation for research, see the rationale section on access to services.
Full details of the evidence and the committee's discussion are in evidence review H: access to services.
Other recommendations for research
First-line treatment of less severe depression
Is peer support an effective and cost-effective treatment in improving outcomes, including symptoms, personal and social functioning and quality of life in adults as a stand-alone treatment in people with less severe depression and as an adjunct to other evidence-based treatments in more severe depression?
What are the mechanisms of action of effective psychological treatments for acute episodes of depression in adults? (This question is applicable to less severe and more severe depression.)
For a short explanation of why the committee made these recommendations for research, see the rationale section on treatment for a new episode of less severe depression.
Full details of the evidence and the committee's discussion are in evidence review B: treatment of a new episode of depression.
First-line treatment of more severe depression
What is the effectiveness and cost effectiveness of combination treatment with acupuncture and antidepressants in people with more severe depression in the UK?
For a short explanation of why the committee made these recommendations for research, see the rationale section on treatment for a new episode of more severe depression.
Full details of the evidence and the committee's discussion are in evidence review B: treatment of a new episode of depression.
Chronic depression
What is the effectiveness, acceptability and safety of monoamine oxidase inhibitors (MAOIs; for example, phenelzine) compared to alternative SSRI or SNRI options in treatment-resistant chronic depression with anhedonia?
How can identifying and focusing on the social determinants of chronic depression, and on the outcomes that matter to people with depression, enable greater precision for targeting the relevant causal factors and mechanisms that contribute to sustained recovery?
For a short explanation of why the committee made these recommendations for research, see the rationale section on chronic depressive symptoms.
Full details of the evidence and the committee's discussion are in evidence review E: chronic depression.
Psychotic depression
What are the most effective and cost-effective interventions for the treatment and management of psychotic depression (including consideration of pharmacological, psychological, psychosocial interventions and electroconvulsive therapy [ECT])?
For a short explanation of why the committee made the recommendation for research, see the rationale section on psychotic depression.
Full details of the evidence and the committee's discussion are in evidence review G: psychotic depression.
Electroconvulsive therapy
Is maintenance electroconvulsive therapy (ECT) effective and safe for relapse prevention in people with severe and recurring depression whose depression has remitted on ECT?
For a short explanation of why the committee made the recommendation for research, see the rationale section on preventing relapse.
Full details of the evidence and the committee's discussion are in evidence review C: preventing relapse.