Augmentation strategies in patients with refractory depression

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

In the evaluation of treatment-resistant or treatment-refractory depression (TRD), true resistance to antidepressant therapy must be distinguished from inadequate dose, duration, or compliance with past antidepressant therapy. Reassessment of the diagnosis may reveal psychiatric comorbidity, the presence of depressive subtypes, or the possibility of a medical etiology. Management of TRD should consider patient-specific factors; drug therapy may be directed by depressive subtype or the presence of psychiatric comorbidity. Increasing the dose or duration of current antidepressant therapy is appropriate for patients who have received inadequate therapy in the past. Augmentation of tricyclic antidepressant (TCA) or selective serotonin reuptake inhibitor (SSRI) therapy with thyroid hormone (T3) or lithium has been shown to be effective in open and controlled trials. Efficacy of other strategies such as higher-dose antidepressant treatment, venlafaxine therapy, combined antidepressant therapy, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), or augmentation with pindolol or buspirone has been less well established, but emerging data from open studies and case reports are encouraging.

Original languageEnglish
Pages (from-to)169-181
Number of pages13
JournalDepression and Anxiety
Volume4
Issue number4
DOIs
StatePublished - Dec 1 1996
Externally publishedYes

Fingerprint

Treatment-Resistant Depressive Disorder
Antidepressive Agents
Therapeutics
Psychiatry
Comorbidity
Buspirone
Pindolol
Electroconvulsive Therapy
Transcranial Magnetic Stimulation
Tricyclic Antidepressive Agents
Serotonin Uptake Inhibitors
Triiodothyronine
Lithium

Keywords

  • augmentation
  • combination therapy
  • lithium
  • refractory depression
  • resistant depression
  • selective serotonin reuptake inhibitors
  • thyroid hormone
  • tricyclic antidepressants

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)
  • Clinical Psychology

Cite this

Augmentation strategies in patients with refractory depression. / Nemeroff, Charles.

In: Depression and Anxiety, Vol. 4, No. 4, 01.12.1996, p. 169-181.

Research output: Contribution to journalArticle

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