Question

A 45-year-old woman with a history of major depression presents with worsening low mood, early morning wakening, poor appetite and passive thoughts of death. She has tried two adequate SSRI trials in the past with partial response and has engaged with CBT. According to RANZCP mood disorder guidelines, which next-step pharmacological strategy is most appropriate?

Accepted Answer

Add a second-generation antipsychotic as augmentation to her current antidepressant

Answer

Switch to another SSRI of the same class

Answer

Commence benzodiazepines as monotherapy

Answer

Stop all medication and rely on psychotherapy alone

Answer

Immediate ECT without further pharmacological trials

Practice question