Major depressive disorder treatment strategies

Psychodynamic supportive psychotherapy (n = 107) has been compared with psychotherapy plus medication (n = 101) in patients with major depressive disorder (93). The medications included venlafaxine, selective serotonin reuptake inhibitors, nortriptyline, and nortriptyline plus lithium. Lithium was used as an augmentation strategy in the patients who took lithium and nortriptyline (number not given). There were no differences in outcomes between the two treatment groups. No adverse effects specific to lithium were reported. 

A classical augmentation strategy for treatment-refractory depression Specifically, may be useful for treatment of cognitive dysfunction and fatigue as residual symptoms of major depressive disorder unresponsive to multiple prior treatments... 

The treatment of major depression in psychiatry is analogous to the treatment of many conditions in general medicine. Thus, patients with these various disorders can benefit from several classes of medications with different mechanisms of action and adverse effects. The development of newer agents with unique spectra of activity requires the parallel development of specific strategies for their optimal use. Later, after a review of the efficacy literature, we suggest such a model to manage the depressed patient. 

Blier, P. (2005). Medication combination and augmentation strategies in the treatment of major depression. In D. J. Stein, D. J. Kupfer, Schatzberg, A. F. (Eds.), The American Textbook of Mood Disorders. American Psychiatric Publishing Inc., Washington DC, 509-524. 

Several subtypes of depression require specific treatment strategies that go beyond a simple course of conventional antidepressant therapy (these subtypes include bipolar depression, major depression with psychotic features, seasonal depression, atypical depression, comorbid anxiety disorder, comorbid substance abuse, double depression [major depression... 

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