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The National Institute for Health and Clinical Excellence (NICE) has today issued an amendment to the guidelines on the management of depression and anxiety in primary and secondary care. The guidance, originally published in December 2004, has been updated following safety advice issued by the MHRA on the prescription of venlafaxine.

The main changes to the anxiety guideline are on the use of pharmacological therapy and the considerations that need to be made before prescribing venlafaxine if appropriate. The main changes to the depression guideline are on the use of antidepressants especially in patients with cardiovascular disease and the special considerations that need to be taken into account when switching treatment to venlafaxine.

Mercia Page, NICE Clinical Practice Centre Director, said: “Both anxiety and depression are common conditions which can have a significant impact on a person’s quality of life. It is important that we amend our guidance to ensure that each guideline remains relevant and useful to healthcare professionals, patients and carers.”
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These amendments bring each guideline into line with the new safety advice from the MHRA on venlafaxine but do not cover other areas where new evidence may be available. The Institute expects to make a decision on a full update of both guidelines later in 2007.

Notes for editors

About NICE

1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

2. NICE produces guidance in three areas of health:

• public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector.
• health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS.
• clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

About the guidance

3. The guidance is available at http://www.nice.org.uk/CG22  (from 25 April 2007).

4. Depression is characterised by a low mood and loss of interest, usually accompanied by one or more of the following - low energy; change in appetite, weight or sleep pattern; poor concentration; feelings of guilt or worthlessness and suicidal ideas.

5. Anxiety is characterised by feelings of apprehension and worry, spontaneous panic attacks, irritability, poor sleeping, avoidance and poor concentration.

About the Medicines and Healthcare products Regulatory Agency (MHRA)

6. The MHRA is the executive arm of the UK's Drug Licensing Authority and is responsible for all aspects of the regulation of medicines in the UK.

7. More information on the MHRA and its advice on venlafaxine can be found on www.mhra.gov.uk.