Update information

Guidance

June 2022: This guideline updates and replaces NICE guideline CG90 (published October 2009).

We have reviewed the evidence on access to services, service delivery, treatment of new episodes of depression, prevention of relapse, further-line treatment, chronic depression, depression with personality disorder, psychotic depression and patient choice.

Recommendations are marked [2022] if the evidence has been reviewed.

Recommendations that have been deleted, or changed without an evidence review

Some recommendations were deleted from the 2009 guideline. Appendix 1 sets out these recommendations and includes details of replacement recommendations. If there is no replacement recommendation, an explanation for the deletion is given.

For recommendations ending [2009, amended 2022] we have made changes without reviewing the evidence. The reasons for the changes are given in appendix 2.

For recommendations ending [2009], we have not reviewed the evidence. In some cases, minor changes have been made – for example, to update links, or bring the language and style up to date – without changing the intent of the recommendation.

Minor changes since publication

September 2024: We added links to relevant technology appraisal guidance in the sections on further-line treatment and treatment-resistant depression.

May 2024: We have simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health).

This is a presentational change only, and no changes to practice are intended.

April 2023: In recommendation 1.4.11 we clarified the timing of the first review after starting antidepressant medication for people aged 18 to 25 years or where there is a particular concern for risk of suicide.

February 2023: We made a correction to the terms used section for the DSM-5 definition of depression.

ISBN: 978-1-4731-4622-8