Augmentation strategies to increase antidepressant efficacy.

Augmentation strategies for the treatment of major depressive disorder (MDD) are needed when patients with MDD have not tolerated or responded to antidepressant monotherapies. Clinicians can employ sequenced treatment steps, preferably coupled with the use of a treatment algorithm, to utilize augmentation strategies that will enable patients to achieve remission. The focus of augmentation therapy has been combining an antidepressant medication with another antidepressant; however, atypical antipsychotics are becoming commonly used to augment antidepressants. Beyond antidepressants and antipsychotics, alternative augmentation strategies include emerging pharmacologic treatments and nonpharmacologic strategies.