Depression Update: A Briefing on the Canadian Mood and Anxiety Disorder Treatment (Canmat) 2023 Depression Guidelines and Advice for Their Application in Primary Care

Authors

  • Jennifer Swainson, MD, FRCPC, Psychiatry University of Alberta, Edmonton; American Board of Obesity Medicine

DOI:

https://doi.org/10.58931/cpct.2024.2123

Abstract

The Canadian Mood And Anxiety Disorder Treatment (CANMAT) guidelines for depression, last published in 2016, have now been updated with literature through to 2023, and have been recently published in 2024 (Lam et al , Canadian J Psych, In press 2024). This 92-page document thoroughly addresses aspects of depression management, using evidence based on the literature, and supplemented by an expert consensus of the 57 co-authors. While thorough, this document remains cumbersome for a busy primary care clinician to sort through and apply to everyday practice. Here, we present a summary of evidence for the treatment of depression, along with practical advice for clinical decision making in primary care. 

Author Biography

Jennifer Swainson, MD, FRCPC, Psychiatry, University of Alberta, Edmonton; American Board of Obesity Medicine

Dr. Jennifer Swainson is is a psychiatrist at the Misericordia Community Hospital in Edmonton with expertise in treating difficult mood disorders and their comorbid conditions. Dr. Swainson is certified by the American Board of Obesity Medicine and has interest in the reciprocal relationships between mood disorders, sleep, and obesity and their subsequent treatment considerations when they co-occur. Dr. Swainson has served on several advisory committees to the College of Physicians and Surgeons of Alberta (CPSA) in regard to CPSA tracking of high risk medications, and considerations for safe prescribing of ketamine for depression. Dr. Swainson is a co-author of the Canadian Network in Mood and Anxiety Treatments (CANMAT) 2023 Depression Treatment Guidelines and was lead author of the 2021 CANMAT Task Force Update on Ketamine for Depression. She is involved in clinical research and has authored numerous other publications focused on ketamine and esketamine for depression and has been an advocate for safe and accessible use of ketamine for mood disorders. Dr. Swainson is an active teacher of students and residents, and is a frequent speaker for family physicians on topics of mood and insomnia. 

References

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. doi:10.1046/j.1525-1497.2001.016009606.x DOI: https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97-170. doi:10.1111/bdi.12609 DOI: https://doi.org/10.1111/bdi.12609

McIntyre RS, Patel MD, Masand PS, Harrington A, Gillard P, McElroy SL, et al. The Rapid Mood Screener (RMS): a novel and pragmatic screener for bipolar I disorder. Curr Med Res Opin. 2021;37(1):135-144. doi:10.1080/03007995.2020.1860358 DOI: https://doi.org/10.1080/03007995.2020.1860358

Mitchell PB, Goodwin GM, Johnson GF, Hirschfeld RM. Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disord. 2008;10(1 Pt 2):144-152. doi:10.1111/j.1399-5618.2007.00559.x DOI: https://doi.org/10.1111/j.1399-5618.2007.00559.x

Sarris J, Ravindran A, Yatham LN, Marx W, Rucklidge JJ, McIntyre RS, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424-455. doi:10.1080/15622975.2021.2013041 DOI: https://doi.org/10.1080/15622975.2021.2013041

Parikh SV, Quilty LC, Ravitz P, Rosenbluth M, Pavlova B, Grigoriadis S, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments. Can J Psychiatry. 2016;61(9):524-539. doi:10.1177/0706743716659418 DOI: https://doi.org/10.1177/0706743716659418

Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JPT, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JPA, Geddes JR. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018 Apr 7;391(10128):1357-1366. doi: 10.1016/S0140-6736(17)32802-7. Epub 2018 Feb 21. PMID: 29477251; PMCID: PMC5889788.

Obesity Canada. The Role of Mental Health in Obesity Management. University of Alberta, Edmonton, Alberta: Obesity Canada; 2024 [updated 2024]. [Available from: https://obesitycanada.ca/guidelines/mentalhealth/].

Chrenek C, Duong B, Khullar A, McRee C, Thomas R, Swainson J. Use of ketamine for treatment resistant depression: updated review of literature and practical applications to a community ketamine program in Edmonton, Alberta, Canada. Front Psychiatry. 2023;14:1283733. doi:10.3389/fpsyt.2023.1283733 DOI: https://doi.org/10.3389/fpsyt.2023.1283733

Swainson J, McGirr A, Blier P, Brietzke E, Richard-Devantoy S, Ravindran N, et al. The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Recommendations for the Use of Racemic Ketamine in Adults with Major Depressive Disorder: Recommandations Du Groupe De Travail Du Réseau Canadien Pour Les Traitements De L'humeur Et De L'anxiété (Canmat) Concernant L'utilisation De La Kétamine Racémique Chez Les Adultes Souffrant De Trouble Dépressif Majeur. Can J Psychiatry. 2021;66(2):113-125. doi:10.1177/0706743720970860 DOI: https://doi.org/10.1177/0706743720970860

Rosenblat JD, Husain MI, Lee Y, McIntyre RS, Mansur RB, Castle D, et al. The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder. Can J Psychiatry. 2023;68(1):5-21. doi:10.1177/07067437221111371 DOI: https://doi.org/10.1177/07067437221111371

Tourjman SV, Buck G, Jutras-Aswad D, Khullar A, McInerney S, Saraf G, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: A Systematic Review and Recommendations of Cannabis use in Bipolar Disorder and Major Depressive Disorder. Can J Psychiatry. 2023;68(5):299-311. doi:10.1177/07067437221099769 DOI: https://doi.org/10.1177/07067437221099769

Published

2024-06-17

How to Cite

1.
Swainson J. Depression Update: A Briefing on the Canadian Mood and Anxiety Disorder Treatment (Canmat) 2023 Depression Guidelines and Advice for Their Application in Primary Care. Can Prim Care Today [Internet]. 2024 Jun. 17 [cited 2024 Jul. 19];2(1):4—10. Available from: https://canadianprimarycaretoday.com/article/view/2-1-swainson

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Articles