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Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol
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Published on: November 21, 2025

Switching treatments for complicated depression.

Maurizio Fava1

  • 1Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, USA.

The Journal of Clinical Psychiatry
|March 3, 2010
PubMed
Summary
This summary is machine-generated.

Many patients do not achieve full remission with initial antidepressants. Switching or augmenting antidepressants offers effective strategies for treatment-resistant depression, tailored to individual patient needs.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Psychiatry

Background:

  • Most patients with depression do not achieve remission with first-line antidepressants.
  • Treatment resistance is common, necessitating further therapeutic strategies.
  • Augmentation or switching antidepressants are common next-step approaches.

Purpose of the Study:

  • To review strategies for managing depression when initial treatment is insufficient.
  • To discuss the efficacy and tolerability of antidepressant augmentation and switching.
  • To highlight the importance of personalized treatment selection for treatment-resistant depression.

Main Methods:

  • Literature review of clinical practice guidelines and research studies.
  • Analysis of augmentation and switching strategies in antidepressant pharmacotherapy.
  • Discussion of drug class switching versus augmentation.

Main Results:

  • Augmentation or switching are viable options for partial responders or non-responders.
  • Switching antidepressants, within or across classes, is generally well-tolerated.
  • Switching appears effective for patients with treatment-resistant depression.

Conclusions:

  • Personalized treatment selection is crucial for optimizing outcomes in depression.
  • Antidepressant augmentation and switching are important therapeutic options.
  • Tailoring treatment to individual patient needs improves management of treatment-resistant depression.