Journal of clinical psychopharmacology
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J Clin Psychopharmacol · Feb 2012
Randomized Controlled Trial Multicenter Study Comparative StudyTreating depression after initial treatment failure: directly comparing switch and augmenting strategies in STAR*D.
Augmenting and switching antidepressant medications are the 2 most common next-step strategies for depressed patients failing initial medication treatment. These approaches have not been directly compared; thus, our objectives are to compare outcomes for medication augmentation versus switching for patients with major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) clinical trial. ⋯ For patients receiving and tolerating aggressive initial antidepressant trials, there is no clear preference for next-step augmentation versus switching. Findings tentatively suggest that those who complete an initial treatment of 12 weeks or more and have a partial response with residual mild depressive severity may benefit more from augmentation relative to switching.