Intervention consultation

The purpose of the intervention consultation seven to 14 days later is to assess the person’s adherence to the medicine, identify any problems, and determine their need for further information and support.

The discussion will explore the person’s tolerance and response to the antidepressant. Table 2 (below) provides a suggested framework for the conversation.

During the initial phase of treatment, there is an increased risk that the patient may experience suicidal ideation because antidepressants can increase both energy and motivation levels, which start to rise prior to the depression beginning to lift.

The person may have more energy plus motivation to act on suicidal intent before their mood starts to improve. Although particularly high in young people under the age of 25 years, this risk can occur in any person newly starting an antidepressant. This is why it is crucial to know local escalation routes and contact details. 

If, during the consultation, any patient expresses suicidal ideation or discloses thoughts or plans to harm themselves, it is essential that these risks are highlighted to their GP immediately.

If the person is in crisis and has active plans to harm themselves or end their life, refer them to the local urgent 

care service. If concerned that a patient’s life is in imminent danger, contact 999 or A&E. A previous article on suicide prevention is available to refresh your knowledge.

When closing the consultation, confirm whether the person has any other questions they want to ask or whether there is anything else they want to share. Thank them for sharing anything they have talked to you about.