Clinical Practice Pearls: Managing Patients with Major Depressive Disorder Showing an Inadequate Response to First-Line Therapies

Podcast #3: Recurrent MDD treatment once SSRIs are no longer effective
Post-Test/Evaluation

Exit Survey

Questions marked with a * are required

20%

Contact Information

First Name

Last Name

Email Address

Credentials/Degree (MD, DO, RN, etc.)

Date of Participation

A 55-year-old man is diagnosed with severe depression. His PHQ-9 score is 21 and GAD-7 score is 8. Sertraline is initiated at 50 mg/d, increasing to 100 mg/d after 1 week. At his follow up 4 weeks later, he shows improvement in mood and interest, but sleep and concentration remain disrupted. PHQ-9 total score is 16. Sertraline is increased to 150 mg/d, and then to 200 mg/d. Anxiety is improved, with a PHQ-9 score of 11, driven by residual symptoms of insomnia, low energy, and problems with concentration/cognition. Interest, mood, and appetite are near normal. What would be a reasonable next step?

Switch to an SNRI

Switch to bupropion

Switch to vortioxetine

Switch to a different SSRI

Patient preferences should be considered when recommending hospitalization to treat moderate-to-severe alcohol use disorder based on an AUDIT score of 16.

True

False