Antidepressant Therapy: When to Switch vs Augment
DISCLAIMER
The content provided in this Substack post is for entertainment and informational purposes only and is not intended to serve as medical advice. The views and opinions expressed herein are those of the writer and should not be taken as definitive or authoritative. Readers should not rely solely on the information provided in this post to make decisions about patient care. Instead, use this content as a starting point for further research and consult a qualified healthcare professional before making any changes to treatment or medication regimens.
As Psychiatric Mental Health Nurse Practitioners (PMHNPs), we are no strangers to the challenges posed by Major Depressive Disorder (MDD). Diagnosis and initial treatment are just the tip of the iceberg; the real complexity often lies in the course of management, especially when faced with suboptimal responses or treatment-resistant cases. Which… let’s be honest: approximately 60-70% of patients trialled on their first antidepressant trial will not achieve remission. Because of this, an understanding of when to switch vs when to augment antidepressant therapies is absolutely critical to proper psychiatric care.
This article aims to provide a framework to help conceptualize the pros & cons of each strategy. We'll explore the clinical indications that favor one approach over the other, the advantages and drawbacks of each, and offer insights into the nuances of switching classes of medication.
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