"So is it a mistake to give these patients an antidepressant? I think the mistake is not that you give an antidepressant; the mistake may be [thinking that is] all you need to do," he said. He added: "If clinical management is really accounting for most of the change, you can’t just give an antidepressant and walk away, and not do the clinical management."
A caveat, however, is that the about 50% of patients with short-duration and late-onset depression who do not respond to placebo with clinical management will need further treatment, he said.
Dr. Nelson disclosed that he has received honoraria from Korea Otsuka International Asia Arab Co. and has served as a paid consultant or advisory board member for Bristol-Myers Squibb, Cenestra Health, and other companies. He also has received research support from the National Institute of Mental Health and the Health Resources and Services Administration.