Antidepressants augmentation

Cheryl Buhay, Primary Care Liaison Psychiatrist, will discuss what we need to consider when our patient doesn’t respond to antidepressant medications, including medication, illness, and patient factors.

Topics

intro
Play now
tell us about the 5 P’s (Presenting problem, Predisposing factors, Precipitating factors, Perpetuating factors, Protective factors.)
Play now
considerations when our patient appears not to be responding to antidepressant treatments
Play now
medication factors, what to consider
Play now
illness factors
Play now
patient factors
Play now
when would we consider remaining on the current treatment?
Play now
when would we consider moving to a different antidepressant?
Play now
combining/augmenting medications
Play now
specialists/mental health involvement when prescribing lithium
Play now
what are the indications for antipsychotics?
Play now
other medications
Play now
SSRI and sexual dysfunction
Play now
back to basics... when antidepressant augmentation still provides an inadequate response
Play now
how long do we continue with treatment?
Play now
take-home messages
Play now

Take home messages

Back to basics with a systematic approach
Plan collaboratively with your patient
Don’t forget non-pharmacological strategies and management of comorbid conditions
You can always seek advice. Specialist mental health input – GP Mental Health Advice Line

Resources

The Maudsley Prescribing Guidelines 14th Edition. Taylor et al. 2021
Depression in adults: treatment and management NICE guideline (2022)
Mood Disorders Clinical Practice Guideline RANZCP (2022 update)
Treatment options for difficult-to-treat depression Dr Cheryl Buhay

Presenter

Cheryl Buhay

Primary Care Liaison Psychiatrist

Cheryl is a Fellow of the Royal Australian and New Zealand College of Psychiatrists and an Honorary Senior Lecturer with the University of Auckland.

She is working for Te Whatu Ora - Waitematā District’s Specialist Mental Health Services as a Primary Care Liaison Psychiatrist, providing specialist mental health support to GPs in the area. She covers the GP Mental Health Advice Line during the week, is involved in GP teaching and supervision, and over the years has developed mental health resources for Primary Care, first responders and other health provider groups.