Figure 7.1.

Algorithm for sequential treatment after suboptimal response to initial antidepressant medication.

Note. This algorithm refers primarily to medication treatments. Psychological treatments (see Table 3.2) should also be considered when patients have suboptimal responses to an initial medication. Neuromodulation treatments (see Table 8.3) are generally considered after a switch or adjunctive medication strategy has failed (i.e., for treatment-resistant depression). DTD = difficult-to-treat depression; MDD = major depressive disorder; TCA = tricyclic antidepressant; IN = intranasal; IV = intravenous; TRD = treatment-resistant depression; XR = extended release.