oa Editorial (Is there a Need for Safety Monitoring Guidelines for Antidepressant Treatment?)

Antidepressants are amongst the most commonly prescribed classes of drugs and their use continues to grow. The World Health Organisation estimates that depression effects approximately 121 million people worldwide, with 26 million people receiving some form of medical care for depression [1]. A large number of these people will be treated with antidepressants. Moreover, antidepressants are commonly administered to special populations, such as the elderly, children and women during reproductive life stages. Depression is also commonly associated with comorbid physical illnesses [2], being overweight [3], tobacco smoking [4], poor diet [5] and lack of physical activity [6]. Large numbers of people being treated, often with vulnerabilities, increases the likelihood of adverse drug reactions to antidepressant treatment. Adverse effects associated with antidepressant treatments have been well documented and vary with agent, dose and interindividual factors. Effects range from common to very rare, mild to life threatening. Adverse events are part of the landscape in prescribing medications. Treatment outcomes are optimised when management of safety issues are an integral part of practice. I recently had the privilege of being part of an expert working group that recently published safety monitoring guidelines for antidepressant treatments [7]. These guidelines present an overview of screening and safety considerations for antidepressant treatment and make recommendations for safety monitoring. Recommendations are made to assist with the decision to treat, including the diagnostic work up and assessing the risk versus benefit of treatment, screening and assessments prior to the initiation of treatment and recommendations for ongoing monitoring during treatment. Surprisingly, these guidelines are the first of their type, although there are previous safety monitoring guidelines for schizophrenia [8], bipolar disorder [9] and specific agents such as clozapine [10]....