Introduction and aimsAcquired brain injury (ABI) -whether due to stroke, trauma or any other cause -is frequently complicated by depression, which can interfere with rehabilitation, leading to poorer outcomes. The use of antidepressants in the treatment of depression following ABI is increasingly widespread. Because it may not be practical to involve a psychiatrist in all cases, first line management is usually undertaken by general clinicians. However, at present, many people are given antidepressant medication as a matter of routine -often without their knowledge and without any clear treatment plan.The aim of these guidelines is to provide the general physician, GP or other clinician with a safe approach to managing minor to moderate depression in the context of rehabilitation or recovery from ABI, and to identify those individuals who require referral to mental health services.The guidelines focus on the use of antidepressant drugs, but these are by no means the only way to manage depression following ABI, and it is important in any event to consider other contributing factors before reaching for the prescription pad. Alternative interventions may include simple measures to address environmental or other factors which contribute to low mood (such as missing their home and family, or worries about life outside hospital), and non-pharmacological interventions, such as 'talking therapies' , for patients who have the cognitive and communicative abilities to engage successfully.The guidelines have been prepared in accordance with the principles laid down by the AGREE Collaboration (Appraisal of Guidelines for REsearch and Evaluation). 1 A summary of the guideline development process is given in Table 1. Although developed specifically with brain injury in mind, the main principles applied here may also be applicable in other conditions, especially where the person's ability to interact is impaired.I CLINICAL GUIDANCE 268