Treatment of Depression

Nathan S. Kline, MD
JAMA. 1978;240(21):2287-2288. doi:10.1001/jama.1978.03290210069035.
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There are an estimated 12 million to 20 million patients with depression presently in need of treatment. Approximately 20,000 psychiatrists are using pharmacotherapy. Even if they dealt with no other condition, this would entail a case load of 600 to 1,000 active patients per psychiatrist. Obviously this places the responsibility for dealing with depressed patients squarely on the family physician, the general practitioner, and the internist. Physicians in other areas should recognize and treat this illness when it occurs in conjunction with their own specialty. In general, referrals to the psychiatrist should be reserved for difficult diagnostic problems and patients not responsive to ordinary treatment.

Researchers report on preparations that produce relief of depression in days or even minutes, but these may not be available for years to come. Most failures in the pharmacologic treatment of depression are because of inadequate dosage and plain impatience. Every medical practitioner should be


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