| Level 1: | Citalopram monotherapy. |
| Level 2: | Either switching to sertraline, bupropion SR, venlafaxine XR, or cognitive behavioral therapy (CBT) OR Augmenting with bupropion SR, venlafaxine XR, or CBT. |
| Level 3: | Either switching to nortriptyline or mirtazapine OR Augmenting with lithium or triiodothyronine (T3). |
| Level 4: | Either switching to tranylcypromine OR Switching to venlafaxine XR + mirtazapine. |
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