Partial Responders to Antidepressant Treatment: Switching Strategies

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In the STAR*D trial, approximately two thirds of patients with depression did not remit after the initial antidepressant monotherapy treatment. The most favorable option for antidepressant nonresponders is switching medications. Partial responders may prefer augmenting the initial medication with a second agent, but in some cases, such as when intolerable adverse events occur, switching may be the appropriate strategy. Methods for switching vary and choosing the appropriate approach will depend on factors such as whether or not the new medication is in the same antidepressant class as the initial agent, the potential for drug interactions, and the severity of side effects.