Table 7.
Levels of recommendation concerning adjunctive treatment for resistant patients during maintenance phase and recommended dosages for medication options
| Treatment modality to add | Grading | ||
|---|---|---|---|
| In terms of efficacy | In terms of recommendation | Dosage | |
| RLAI | 1 | 1 | Up to 100 mg/mo |
| Aripiprazole | 2 | 2 | Up to 30 mg/d |
| Ziprasidone | 2 | 2 | Up to 160 mg/d |
| Gabapentin | 3 | 3 | Up to >2500 mg/d |
| Phenytoin | 3 | 3 | 380 mg/d |
| Choline | 4 | 4 | – |
| Chromium | 4 | 4 | – |
| Clozapine | 4 | 4 | Up to 600 mg/d |
| ECT | 4 | 4 | – |
| Leviracetam | 4 | 4 | Up to 3000 mg/d |
| Lithium plus lamotrigine or valproate | 4 | 4 | Usual recommended dosages |
| L-Thyroxine | 4 | 4 | 500 μg/d |
| Magnesium | 4 | 4 | – |
| n-3 fatty acids | 4 | 4 | – |
| Nimodipine | 4 | 4 | Up to 360 mg/d |
| Olanzapine | 4 | 4 | Up to 30 mg/d |
| Primidone | 4 | 4 | Up to 250 mg/d |
| Ramelteon | 4 | 4 | 8 mg/d |
| Tryptophan | 4 | 4 | |
| Aripiprazole plus lamotrigine | NR | NR | |
| Memantine | NR | NR | |
| N-acetyl cysteine | NR | NR | |
| Pramipexole | NR | NR | |
| Verapamil | NR | NR |
Abbreviations: DBS, deep brain stimulation; ECT, electroconvulsive therapy; NR, not recommended; TMS, transcranial magnetic stimulation.