{ "schema_version": 1, "kind": "condition", "id": "depression", "name": "Major depressive disorder (mild-to-moderate)", "category": "chronic", "sources": "eMC SmPC, Efexor XL 150 mg prolonged release capsules (Viatris), sections 4.1 and 4.2 · Fluoxetine 20 mg Capsules SmPC section 4.2 Posology and method of administration (eMC product 11909) · LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070)", "review_status": "reviewed", "verified_against": "eMC SmPC, Efexor XL 150 mg prolonged release capsules (Viatris), sections 4.1 and 4.2 · Fluoxetine 20 mg Capsules SmPC section 4.2 Posology and method of administration (eMC product 11909) · LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070) · Major Depressive Disorder - disease-level clinical article (depression-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 587, "generic": "Fluoxetine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg once daily in morning, titrate after 3-4 weeks up to max 60 mg daily", "adult_duration": "Long-term (continue 6 months post-remission)", "dose_source": "Fluoxetine 20 mg Capsules SmPC section 4.2 Posology and method of administration (eMC product 11909)", "rationale": "First-line SSRI with activating profile and long half-life (less discontinuation syndrome)", "cautions": [ "Warn patient that onset of antidepressant effect takes 2-4 weeks.", "Monitor closely for suicidal ideation in young adults during initial weeks.", "Do not combine with MAO inhibitors or serotonergic drugs (serotonin syndrome)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 8-17 yrs (specialist CAMHS supervision): 10 mg once daily, titrate to 20 mg", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "8 to 17 years", "age_min_months": 96, "age_max_months": 215, "dose_text": "10 mg once daily, titrated to 20 mg - under specialist CAMHS supervision" } ], "peds_doses": null, "brands": [ { "trade_name": "FLOROSIN 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHILOZAC 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUOXETINE 20 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 18.6, "pack_count": 10, "unit_price": 1.86, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ELEVAMOOD 20 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 56.0, "pack_count": 28, "unit_price": 2.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OCTOZAC 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHILOZAC 20MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 75.0, "pack_count": 30, "unit_price": 2.5, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROZAC 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ELI LILLY", "price_egp": 118.0, "pack_count": 14, "unit_price": 8.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUOXETINE 20 MG H.G.CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "depression" }, { "id": 588, "generic": "Sertraline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50 mg once daily, titrate by 50 mg steps at 2-3 week intervals to max 200 mg daily", "adult_duration": "Long-term (continue 6 months post-remission)", "dose_source": "LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070)", "rationale": "Preferred SSRI in patients with cardiovascular disease or elderly", "cautions": [ "Do not combine with MAO inhibitors (risk of fatal serotonin syndrome).", "Monitor closely for suicidal ideation during initial weeks (especially in patients <25 years).", "Gastrointestinal side effects (nausea, diarrhea) are common initially.", "Taper dose gradually when discontinuing to prevent withdrawal symptoms.", "Caution with antiplatelets or anticoagulants (increased bleeding risk)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pediatric use restricted to OCD under specialist supervision", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OPIRALINE 50 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 29.0, "pack_count": 20, "unit_price": 1.45, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AGRELOCIT 50 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 34.8, "pack_count": 20, "unit_price": 1.74, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPR-STAT 50MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SESERINE 50MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 75.0, "pack_count": 30, "unit_price": 2.5, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERPASS 50MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 102.0, "pack_count": 30, "unit_price": 3.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SIRTO 50MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 34.0, "pack_count": 10, "unit_price": 3.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOODAPEX 50 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 111.0, "pack_count": 30, "unit_price": 3.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUSTRAL 50 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "VIATRIS", "price_egp": 136.0, "pack_count": 20, "unit_price": 6.8, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "depression" }, { "id": 590, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Major Depressive Disorder - disease-level clinical article (depression-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Evaluation for suicidal or homicidal ideation is mandatory at each visit." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "depression" }, { "id": 589, "generic": "Venlafaxine", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 75.0, "adult_dose": "Prolonged release: 75 mg once daily. Increase at intervals of 2 weeks or more (not less than 4 days) up to a maximum of 375 mg/day", "adult_duration": "Continue for at least 6 months after remission; taper over at least 1-2 weeks, and considerably longer in practice, when stopping", "dose_source": "eMC SmPC, Efexor XL 150 mg prolonged release capsules (Viatris), sections 4.1 and 4.2", "rationale": "30 live products. The condition currently holds two SSRIs and nothing else - venlafaxine is the standard next step for a patient who has not responded to an adequate SSRI trial, and the same SmPC also covers generalised anxiety, social anxiety and panic disorder.", "cautions": [ "Dose-related rise in blood pressure. Measure blood pressure before starting and after each increase, and think hard before exceeding 150 mg/day in a hypertensive patient.", "Withdrawal reactions are more severe and more common than with the fluoxetine and sertraline already listed - never stop abruptly, and warn the patient before they start.", "More toxic in overdose than an SSRI - weigh this where there is self-harm risk, and limit the quantity dispensed.", "Monitor closely for emergent or worsening suicidal thinking in the first weeks and in anyone under 25.", "Do not combine with a monoamine oxidase inhibitor - leave 14 days between them. Efexor XL 150 mg hard prolonged release capsules SmPC section 4.5 (eMC product 1219): \"Venlafaxine must not be used in combination with irreversible non-selective MAOIs.\" and \"Venlafaxine must not be initiated for at least 14 days after discontinuation of treatment with an irreversible non-selective MAOI.\" The label also asks for 7 days the other way round, before an MAOI is started; the card's single 14-day gap is the more restrictive of the two.", "Do not add to the fluoxetine or sertraline in this row - switch, with an appropriate cross-taper.", "Venlafaxine can cause QT prolongation and arrhythmia, chiefly in overdose." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not recommended in children and adolescents - trials failed to demonstrate efficacy and there were more self-harm and hostility events.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "VENOXOR 75 MG 28 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 82.0, "pack_count": 28, "unit_price": 2.93, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENLAFAXINE 75MG SR 7 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 21.0, "pack_count": 7, "unit_price": 3.0, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VEXAMOD 75MG SR 10 CAPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLOBEXOR 75MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 48.0, "pack_count": 14, "unit_price": 3.43, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IDIXOR XR 75 MG 7 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI) > NOVELL PHARMA", "price_egp": 32.5, "pack_count": 7, "unit_price": 4.64, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EFEXOR XR 75MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WYETH AYERST LEDERLE-CANADA > VIATRIS EGYPT", "price_egp": 158.0, "pack_count": 14, "unit_price": 11.29, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EFFEGAD 75 MG 30 E.R. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EPCI > HIKMA PHARMA", "price_egp": 90.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENLLAMASH 75 MG 30 EXT. REL. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 159.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "depression" } ] }