Pharmacologic Treatment Strategies for the Depressed, Poorly Responsive Patient

Several alternative strategies for helping depressed patients who have not responded to initial therapy are offered. Enhancing existing drug therapy is usually more advantageous than starting over with a new medication because of the shorter response time. A structurally different antidepressant is more likely to induce a remission than a medication of similar configuration. ECT is the most powerful treatment choice for depression, especially when suicidal or psychotic features are present.