Use of antidepressants in primary health care: indications, challenges, and clinical perspectives – a narrative review

Abstract

Introduction: Depression is one of the most prevalent mental disorders worldwide and represents a major public health concern, being a leading cause of healthcare utilization, particularly in primary care settings. In this context, antidepressants are the main pharmacological treatment and are widely prescribed by general practitioners. Objective: To analyze the use of antidepressants in primary health care, addressing their main indications, prescribing patterns, treatment adherence, adverse effects, and challenges in clinical practice. Methodology: This is a narrative literature review conducted through searches in PubMed, SciELO, and Google Scholar databases. The descriptors “antidepressants”, “primary health care”, “depression”, and “pharmacological treatment” were used, combined with Boolean operators AND and OR. Articles published in the last 10 years, in English and Portuguese, addressing the use of antidepressants in primary care were included. Duplicates, unrelated studies, and articles with restricted access were excluded. Conclusion: The use of antidepressants in primary care is essential for managing depressive and anxiety disorders, with selective serotonin reuptake inhibitors being the first-line treatment. However, challenges such as inappropriate prescribing, low treatment adherence, and insufficient patient monitoring persist, highlighting the need for professional training and strengthened longitudinal care to improve clinical outcomes.