The American College of Physicians (ACP) has issued updated guidelines for the treatment of major depressive disorder (MDD). The recommendations include both nonpharmacologic and pharmacologic interventions for adults in the acute phase of MDD based on a systematic review of available evidence. For initial treatment of moderate to severe MDD, ACP recommends monotherapy with either cognitive behavioral therapy (CBT) or a second generation antidepressant (eg, selective serotonin reuptake inhibitors [SSRIs], serotonin norepinephrine reuptake inhibitors [SNRIs], bupropion, mirtazapine, nefazodone, trazodone, vilazodone, vortioxetine). If an antidepressant is initiated, the guidelines suggest starting treatment with a low dose to reduce the chances of side effects and improve adherence. A combination of CBT and second generation antidepressant as initial treatment was also suggested as an alternative treatment option. For patients with moderate to severe MDD who do no...