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PG_Depression3rdEd

PG_Depression3rdEd

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PRACTICE GUIDELINE FOR THE
 Treatment of Patients WithMajor Depressive Disorder
Third Edition
WORK GROUP ON MAJOR DEPRESSIVE DISORDER
 Alan J. Gelenberg, M.D., Chair Marlene P. Freeman, M.D. John C. Markowitz, M.D. Jerrold F. Rosenbaum, M.D. Michael E. Thase, M.D. Madhukar H. Trivedi, M.D.Richard S. Van Rhoads, M.D., Consultant
INDEPENDENT REVIEW PANEL
 Victor I. Reus, M.D., Chair J. Raymond DePaulo, Jr., M.D. Jan A. Fawcett, M.D.Christopher D. Schneck, M.D.David A. Silbersweig, M.D. This practice guideline was approved in May 2010 and published in October 2010. A guideline watch, summarizingsignificant developments in the scientific literature since publication of this guideline, may be available athttp://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx.
Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline maybe reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx.
 
FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST
 The Work Group on Major Depressive Disorder reportsthe following potentially competing interests for the pe-riod from May 2005 to May 2010:Dr. Gelenberg reports consulting for Eli Lilly and Com-pany, Pfizer, Best Practice, AstraZeneca, Wyeth, Cyber-onics, Novartis, Forest Pharmaceuticals, Inc., GlaxoSmith-Kline, ZARS Pharma, Jazz Pharmaceuticals, Lundbeck, Takeda Pharmaceuticals North America, Inc., eResearch Technology, Dey Pharma, PGxHealth, and Myriad Genet-ics. He reports serving on speakers bureaus for Pfizer,GlaxoSmithKline, and Wyeth. He reports receiving re-search grant funding from Eli Lilly and Company, Pfizer,and GlaxoSmithKline. He reports stock ownership inHealthcare Technology Systems.Dr. Freeman reports that she received research supportfrom the Meadows Foundation, the National Institute for Mental Health, the U.S. Food and Drug Administration,the Institute for Mental Health Research, Forest, Glaxo-SmithKline and Eli Lilly and Company (investigator-initiated trials), and Pronova Biocare (research materials).She received an honorarium for case-based peer-reviewedmaterial for AstraZeneca’s website. She reports consultingfor Ther-Rx, Reliant, and Pamlab. She reports receivingan honorarium for speaking at an APA continuing medicaleducation program that was sponsored by Forest and anhonorarium for speaking at a continuing medication edu-cation program sponsored by KV Pharmaceuticals. Shereports receiving an honorarium from Leerink Swann forparticipating in a focus group.Dr. Markowitz reports consulting for Ono Pharma-ceutical Co., Ltd. (2005). He reports receiving researchsupport from Forest Pharmaceuticals, Inc. (2005). He re-ports receiving grant support from the National Instituteof Mental Health (2005–2013), the National Alliance forResearch in Schizophrenia and Depression (2005), and MINT: Mental Health Initiative (2005). He reports re-ceiving royalties from American Psychiatric Publishing, Inc.(2005–2010), Basic Books (2005–2010), Elsevier (2005–2010), and Oxford University Press (2007–2010).Dr. Rosenbaum reports attending advisory boards forBristol-Myers Squibb, Cephalon, Cyberonics, Forest Phar-maceuticals, Inc., Eli Lilly and Company, MedAvante,Neuronetics, Inc., Novartis, Orexigen Therapeutics, Inc.,Organon BioSciences, Pfizer, Roche Diagnostics, Sanofi-aventis, Shire, and Wyeth. He reports consulting for Aus-pex Pharmaceuticals, Compellis Pharmaceuticals, EPIXPharmaceuticals, Neuronetics, Inc., Organon BioSci-ences, Somaxon, and Supernus Pharmaceuticals, Inc. Hereports receiving honoraria from lectureships for Boeh-ringer Ingleheim, Bristol-Myers Squibb, Cyberonics,Forest Pharmaceuticals, Inc., Eli Lilly and Company, andSchwartz Pharma. He was involved in the creation of the Massachusetts General Hospital Psychiatry Academy (MGH-PA) and has served as a panelist in four satellitebroadcast programs. MGH-PA programs that have indus-try support are always multi-sponsored, and curriculumdevelopment by the Academy is independent of sponsor-ship; the curricula from January 2005 to March 2009 in-cluded sponsorship support from AstraZeneca, Bristol- Myers Squibb, Cephalon, Eli Lilly and Company, ForestPharmaceuticals, Inc., GlaxoSmithKline, Janssen Medical Affairs LLC, Ortho-McNeil Pharmaceutical, sanofi-aventis, Shire, and Wyeth. He reports equity holdings inCompellis Pharmaceuticals, MedAvante, and Somaxon.Dr. Thase reports that he provided scientific consulta-tion to AstraZeneca, Bristol-Myers Squibb, Eli Lilly &Company, Forest Pharmaceuticals, Inc., Gerson LehmanGroup, GlaxoSmithKline, Guidepoint Global, H. Lund-beck A/S, MedAvante, Inc., Neuronetics, Inc., Novartis,Otsuka, Ortho-McNeil Pharmaceuticals, PamLab, L.L.C.,Pfizer (formerly Wyeth-Ayerst Laboratories), Schering-Plough (formerly Organon), Shire U.S., Inc., SupernusPharmaceuticals, Takeda (Lundbeck), and Transcept Phar-maceuticals. He was a member of the speakers bureaus for AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Com-pany, GlaxoSmithKline, Pfizer (formerly Wyeth-AyerstLaboratories), and Schering-Plough (formerly Organon).He received grant funding from Eli Lilly and Company,GlaxoSmithKline, the National Institute of Mental Health,the Agency for Healthcare Research and Quality, andSepracor, Inc. He had equity holdings in MedAvante, Inc.,and received royalty income from American PsychiatricPublishing, Inc., Guilford Publications, Herald House,Oxford University Press, and W.W. Norton and Company.His wife was employed as the group scientific director forEmbryon (formerly Advogent), which does business withBristol-Myers Squibb and Pfizer/Wyeth.Dr. Trivedi reports that he was a consultant to or onspeaker bureaus for Abbott Laboratories, Inc., Abdi Ibra-him, Akzo (Organon Pharmaceuticals, Inc.), AstraZeneca,Bristol-Myers Squibb Company, Cephalon, Inc., Cyber-onics, Inc., Eli Lilly and Company, Evotec, Fabre KramerPharmaceuticals, Inc., Forest Pharmaceuticals, Glaxo-SmithKline, Janssen Pharmaceutica Products, L.P., Johnson& Johnson P.R.D., Meade-Johnson, Medtronic, Neuro-netics, Otsuka Pharmaceuticals, Parke-Davis Pharmaceuti-
Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline maybe reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx.
 
cals, Inc., Pfizer, Inc., Sepracor, Shire Development, Solvay Pharmaceuticals, VantagePoint, and Wyeth-Ayerst Labo-ratories. He received research support from the Agency forHealthcare Research and Quality, Corcept Therapeutics,Inc., Cyberonics, Inc., Merck, National Alliance for Re-search in Schizophrenia and Depression, National Insti-tute of Mental Health, National Institute on Drug Abuse,Novartis, Pharmacia & Upjohn, Predix Pharmaceuticals(Epix), Solvay Pharmaceuticals, Inc., and Targacept.Dr. Van Rhoads reports no competing interests. The Independent Review Panel, including Drs. Reus,DePaulo, Fawcett, Schneck, and Silbersweig, report nocompeting interests. The Independent Review Panel re- viewed this guideline to assess potential biases and foundno evidence of influence from the industry and other re-lationships of the Work Group disclosed above. TheSteering Committee on Practice Guidelines also reviewedthis guideline and found no evidence of influence fromthese relationships. The development process for thisguideline, including the roles of the Work Group, Inde-pendent Review Panel, Steering Committee, APA Assem-bly, and APA Board of Trustees is described in “Overviewof Guideline Development Process” on p. 11.
Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline maybe reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx.

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