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Background. Family physicians often provide the first line of treatment for patients with depression. Many effective drugs are now available for the pharmacologic treatment of depression.Methods: We searched MEDLINE from 1991-96 under the topics of depressive disorders/treatment and antidepressant medications. Other sources were found by back-referencing from these references and from pharmacology texts.Results: Although antidepressants appear to be equally effective, selective serotonin reuptake inhibitors are frequently the drugs of choice because of their safety profile and less troublesome side effects.Conclusions: When prescribing antidepressant medications, the clinician must educate patients about potential side effects and about the amount of time that must be allowed for therapeutic efficacy. Drug interactions and concurrent medical conditions are important factors in the choice of an antidepressant.

A case is made for the small-group consensus process as an effective utilization-focused dissemination method. Interventions based on group dynamics and sensitive to local practice contexts can be useful in facilitating adoption of guidelines by physicians in group practices.

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