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In September 2009, NICE will publish two new guidelines in the field of depression - depression in adults and depression in chronic physical health problems. The guideline on depression in adults includes major changes to current prescribing practice. The most important of these is the recommendation that antidepressants drugs are switched if there is no response after three to four weeks. This reflects the growing recognition that antidepressants have a prompt onset of action and that failure to respond early in treatment predicts ultimate failure to respond. Also included is a strengthened recommendation for the use of additive antipsychotics (olanzapine, quetiapine, risperidone and aripiprazole) as a first-line option in refractory depression. The guideline on depression in chronic physical health problems mirrors recommendations in the adult guideline and adds specific recommendations for the use of antidepressants in a variety of physical disorders. In this guideline, drug choice is based to some extent on drug interactions and contra-indications. The outcome of this is that less often used drugs (mianserin, mirtazapine, trazodone) are recommended in a number of situations.