When do you choose to switch to antidepressants vs augmentation in treatment-resistant depression?  

When I approach depression that has been resistant to many antidepressant trials, I consider the following: First, I reassess the diagnosis. This includes considering comorbidities such as menopause symptoms, ED symptoms, exacerbation of chronic medical issues, and onset of MNCD. I ensure I have co...

Treatment-resistant depression has been profoundly rare in my private practice over the past 34 years. Most patients with the diagnosis of treatment-resistant depression that I see aren't really depressed. They have a pessimistic explanatory style which doesn't respond to any medications. If they do...

Treatment-resistant depression is an interesting condition. I would first do a thorough interview, get extensive collateral, and try to do a good differential before thinking about treatment options. Is this TRD or undiagnosed bipolar depression or bipolar 1 or 2 starting as depression before having...

If the first antidepressant, at full therapeutic doses, and after sufficient time to maximize its efficacy, has shown partial benefit, I would most likely not taper and stop it, but rather use a second-generation antipsychotic medication. If, however, I thought there could be some elements of bipol...