At Centrum Pharmacy, we understand that antidepressant therapy isn’t one-size-fits-all. If you’re struggling with side effects or feel your current medication isn’t working, you’re not alone—and you don’t have to guess your next steps alone either. Our pharmacists are trained in the complexities of antidepressant pharmacotherapy and can work with your doctor to make personalized treatment recommendations that improve outcomes while minimizing trial-and-error.
A recent re-analysis of the landmark OPTIMUM study (Optimizing Outcomes of Treatment-Resistant Depression in Older Adults) reinforces the importance of strategic treatment planning. The original study found that augmenting an existing antidepressant regimen—rather than switching to a different one—can be more effective in elderly patients with treatment-resistant depression (TRD). New findings show this advantage holds especially for patients who have tried fewer than three antidepressants in the past.
Why Augmentation May Work Better Than Switching
Adding a second medication such as aripiprazole or bupropion to an existing antidepressant (rather than replacing it entirely) showed better psychological well-being and higher remission rates in the OPTIMUM cohort. However, the benefits were most significant in patients with fewer than three failed antidepressant trials—suggesting the earlier augmentation is considered, the better.
Combining Antidepressants May Be More Effective Than Switching—Here’s What Our Pharmacists Can Do to Help
The study looked at potential moderators that might influence whether augmentation or switching works better, including:
- Age
- Executive dysfunction
- Medical comorbidities
- Coexisting anxiety
- Severity of treatment resistance
Interestingly, only the severity of treatment resistance—defined as having tried three or more antidepressants without success—significantly impacted outcomes. For patients with higher treatment resistance, augmentation alone may not be enough, and alternative treatments like psychotherapy, ketamine, rTMS, or ECT may need to be considered.
What Centrum Pharmacists Can Do for You
Our pharmacists stay current on the latest depression treatment research and work closely with both patients and physicians to enhance outcomes. We consider each person’s medication history, lifestyle, symptom profile, and preferences to:
- Recommend evidence-based augmentation strategies.
- Flag high-risk combinations or side effects.
- Identify when alternative therapies may be more appropriate.
- Collaborate with your family doctor or psychiatrist to streamline and personalize your treatment plan.
We can also suggest a rational antidepressant sequencing strategy such as:
- Sertraline first-line
- Venlafaxine second-line
- Venlafaxine + aripiprazole (or bupropion or nortriptyline) as third-line
- Alternative treatments (e.g., rTMS, ECT) as fourth-line
And remember, psychotherapy can be used at any point and often boosts response rates.
Don’t Settle—Let’s Personalize Your Treatment
At Centrum Pharmacy, we don’t believe in “trial and error” alone. We believe in informed, tailored care grounded in the latest clinical evidence. If your current antidepressant isn’t working—or you’re worried about side effects—speak with one of our pharmacists. Let’s work together to find the most effective, personalized path forward.
Stay Connected with Centrum Pharmacy!
If you found this article helpful, don’t forget to like, share, and Follow to stay up to date on our latest health tips, pharmacy updates, and wellness advice.
Come for the Convenience, Stay for the Service.
Caring for Your Family Since 1999
Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.
