. Author manuscript; available in PMC: 2015 May 7.

Published in final edited form as: Focus (Am Psychiatr Publ). 2010 Fall;8(4):488–500. doi: 10.1176/foc.8.4.foc488

Table 1. Common, Evidence-Based Medication Augmentation Approaches for TRD.

Approach	Highest Level of Support	Comments
Lithium	Several placebo-controlled RCTs	Best data are from studies using TCAs or MAOls; limited data with newer antidepressant medications
Thyroid hormone (T₃)	Several placebo-controlled RCTs	Best data are from studies using TCAs; limited data with newer antidepressant medications
Buspirone	Two placebo-controlled RCTs	One RCT was positive for patients with severe depression (but was not positive overall), the other was negative
Atypical antipsychotics	Several placebo-controlled RCTs for various agents
Additional antidepressants
Bupropion	Open-label studies	Most common approach in clinical practice
Mirtazapine	One placebo-controlled RCT
TCA + SSRI/SNRI	Open-label studies

RCT, randomized controlled trial.