Evidence for the benefits of nonantipsychotic pharmacological augmentation in the treatment of depression

Chia Ming Chang, Soichiro Sato, Changsu Han

    Research output: Contribution to journalReview articlepeer-review

    19 Citations (Scopus)


    Failure to achieve an adequate response after initial antidepressant treatment in patients with depression is common and remains a clinical challenge. In recent years, some atypical antipsychotic agents have been approved by the US Food and Drug Administration for use in an augmentation strategy for major depressive disorder, and other agents are already in common use in clinical practice. We conducted a search of MEDLINE for relevant studies of augmentation strategies using randomized controlled trials and meta-analyses, and we summarize and discuss the various agents other than atypical antipsychotics. Lithium and thyroid hormone augmentation may improve the response of tricyclic antidepressants but not that of selective serotonin reuptake inhibitors. The efficacy of augmentation with modafinil, buspirone, methylphenidate, folic acid, pindolol and lamotrigine is limited or equivocal. Most of the studies have not focused on treatment-resistant depression (TRD). More trials are needed to help develop evidence-based options for augmentation in TRD.

    Original languageEnglish
    Pages (from-to)S21-S27
    JournalCNS Drugs
    Issue numberSUPPL.1
    Publication statusPublished - 2013 May

    Bibliographical note

    Funding Information:
    Conflict of interest Drs Chang and Sato have received honoraria from Korea Otsuka International Asia and Arab. Dr Han has received research grants from GlaxoSmithKline Korea, Eisai Korea, Korea Otsuka International Asia and Arab, Hanlim Pharmaceutical, Janssen Pharmaceuticals Korea, Eli Lilly and Co. Korea, Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea, Korean Research Foundation, and Otsuka Korea. Dr Han has also received honoraria from GlaxoSmithKline Korea, Lundbeck Korea, AstraZeneca Korea, Janssen Pharmaceuticals Korea, Eisai Korea, Abott Korea, Eli Lilly and Company Korea, Norvatis Korea and Otsuka Korea.

    ASJC Scopus subject areas

    • Clinical Neurology
    • Psychiatry and Mental health
    • Pharmacology (medical)


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