Initial follow-up review should typically occur within 2–4 weeks of starting antidepressant therapy, with particular attention to suicidal ideation in the early weeks, especially for those aged 18–25 years or at higher risk NICE CKS.
Follow-up assessments should include checking for ongoing symptoms, impact on daily functioning, adherence to treatment, and adverse effects, ideally using a validated depression questionnaire such as PHQ-9 NICE CKS.
If there is no improvement after 4 weeks of treatment at a recognized therapeutic dose, further assessment should be undertaken to identify modifiable risk factors, consider alternative diagnoses, and discuss options for further treatment NICE CKS.
For ongoing monitoring, reviews should be scheduled at intervals of 4–6 weeks, especially in the first 3 months, to evaluate response, adherence, and side effects, with consideration of using validated outcome measures like PHQ-9 NICE CKS.
In cases of treatment response, continuation of medication for at least 6 months after remission is recommended to reduce relapse risk, with regular review to assess the need for ongoing treatment or tapering NICE CKS.