Augmentation and Combination Pharmacotherapy Trends in Major Depressive Disorder: Results of a Brief Survey of Psychiatrists

Monotherapy Approach Before we discuss these practices, we will summarize the usual monotherapy practices. To date, there are no discrete national guidelines to delineate the stepwise treatment of resistant depression, although many local and regional practices are followed. Available treatment guidelines for depression from various geographical regions and organizations usually assume that a patient is antidepressant-naive and is starting out without prior intervention. We will discuss the usual stepwise approach for depression treatment with this in mind. Actually, many patients do have pre-existing depression and may already be receiving treatment when they are first seen in the office. This scenario may be considered to be an initially treatment-resistant state.