World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders. Part 2: Maintenance Treatment of Major Depressive Disorder-Update 2015

Abstract

These guidelines for the treatment of unipolar depressive disorders systematically review available evidence pertaining to the biological treatment of patients with major depression and produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians assessing and treating patients with these conditions. The relevant data have been extracted primarily from various treatment guidelines and panels for depressive disorders, as well as from meta-analyses/reviews on the efficacy of antidepressant medications and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and was then categorized into five levels of evidence (CE A-F) and five levels of recommendation grades (RG 1–5). This second part of the WFSBP guidelines on depressive disorders covers the management of the maintenance phase treatment, and is primarily concerned with the biological treatment (including pharmacological and hormonal medications, electroconvulsive therapy and other brain stimulation treatments) of adults and also, albeit to a lesser extent, children, adolescents and older adults.

Key words::

• major depressive disorder
• maintenance treatment
• guidelines
• pharmacotherapy
• antidepressants

Acknowledgments

None.

Statement of interest

The preparation of these WFSBP guidelines has not been financially supported by any commercial organization. M. Bauer has received Grant/Research Support from Deutsche Forschungsgemeinschaft, European Commission (FP7), American Foundation for Suicide Prevention, Bundesministerium für Bildung und Forschung (BMBF). He has been a consultant for AstraZeneca, Ferrer Internacional, Janssen, Lilly, Lundbeck, Otsuka, Servier, Novartis, Takeda. He has received speaker honoraria from AstraZeneca, GlaxoSmithKline, Lilly, Lundbeck, Otsuka. Pfizer. H.-J. Möller has received received speaker honoraria from Lundbeck, Roche, Schwabe and Servier. H was on an advisroy board for Lundbeck, Roche, and Servier. Other financial support (expert) from AstraZeneca. J. Angst has received honoraria from AstraZeneca, Lilly, Lundbeck, Lundbeck Institute and Bristol-Myers Squibb.

E. Severus has received honoraria from Servier and Lundbeck.