A 45-year-old man with major depressive disorder has been taking an adequate dose of escitalopram for 8 weeks with partial improvement but persistent ...

Question

A 45-year-old man with major depressive disorder has been taking an adequate dose of escitalopram for 8 weeks with partial improvement but persistent moderate symptoms. He has tolerated the medication well. According to CANMAT, what is an appropriate next pharmacologic strategy?

Accepted Answer

Switch to another first-line antidepressant or consider augmentation with a second antidepressant after optimising the current dose.

Answer

Stop escitalopram and wait 4 weeks before starting any other treatment.

Answer

Add a second-generation antipsychotic such as quetiapine as first augmentation step.

Answer

Add a benzodiazepine as sole augmentation.

Answer

Increase escitalopram to supra-therapeutic doses above recommended maximum.

ca-mccqe1 MCQ (SBA): Treatment-resistant depression

A 45-year-old man with major depressive disorder has been taking an adequate dose of escitalopram for 8 weeks with partial improvement but persistent moderate symptoms. He has tolerated the medication well. According to CANMAT, what is an appropriate next pharmacologic strategy?