Harvard Mental Health Letter

Finding the right depression medication

STAR*D and other studies provide guidance, but the research continues.

In spite of the variety of medication options now available, major depression remains a challenging disease to treat. Only about half of adult patients respond to the first antidepressant prescribed, with only one-third achieving remission.

When symptoms are not adequately relieved by the first antidepressant, patients and their clinicians face a difficult decision. Although two broad strategies exist — switching to a new drug or augmenting the first drug with a second — it hasn't been clear which strategy is best. Most of the research has been on initial treatment, pitting a new drug against an old one. Studies evaluating medication augmentation or switching strategies have usually been short-term and compared a drug to a placebo, rather than to another drug.

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