Consider augmentation or switching strategies when first-line antidepressants are unsuccessful in major depressive disorder

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When treating major depressive disorder that has not responded to an adequate trial of a first-line antidepressant, the current evidence most strongly supports switching to another first-line antidepressant or augmentation with the atypical antipsychotics aripiprazole or quetiapine. Lithium and liothyronine (triiodothyronine) may be used to augment tricyclic antidepressants, but further studies of their use to augment newer antidepressants are needed.

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