Augmentation for resistant depression may include which class of medication?

Augmentation for resistant depression may include which class of medication?

• A. SNRI
• B. SSRI
• C. Atypical antipsychotics
• D. MAOI

Answer: (C)

When treating depression that doesn’t respond adequately to an antidepressant, adding a second agent to boost response is a common strategy. The class that has the strongest evidence for augmentation in resistant depression is atypical antipsychotics. Added in low doses to ongoing antidepressant therapy, they can enhance mood, energy, and overall function by modulating dopamine and serotonin pathways in a way that complements the antidepressant effect. Common examples include aripiprazole and quetiapine. It’s important to monitor for side effects such as weight gain, metabolic changes (glucose and lipid levels), sedation, and movement disorders like akathisia or other extrapyramidal symptoms, and to assess mood stability and potential mania. Other antidepressant classes (like adding another SSRI or SNRI) are not as strongly supported for augmentation in resistant cases, and MAO inhibitors carry significant safety concerns and are not typically used as augmentation agents.

When treating depression that doesn’t respond adequately to an antidepressant, adding a second agent to boost response is a common strategy. The class that has the strongest evidence for augmentation in resistant depression is atypical antipsychotics. Added in low doses to ongoing antidepressant therapy, they can enhance mood, energy, and overall function by modulating dopamine and serotonin pathways in a way that complements the antidepressant effect.

Common examples include aripiprazole and quetiapine. It’s important to monitor for side effects such as weight gain, metabolic changes (glucose and lipid levels), sedation, and movement disorders like akathisia or other extrapyramidal symptoms, and to assess mood stability and potential mania.

Other antidepressant classes (like adding another SSRI or SNRI) are not as strongly supported for augmentation in resistant cases, and MAO inhibitors carry significant safety concerns and are not typically used as augmentation agents.