Volume 5, Number 3

Special Report
When SSRIs Fail: A Review of Switching Strategies in Patients Resistant to an Initial SSRI

Charles DeBattista, DMH, MD, and Hugh Brent Solvason, PhD, MD

Dr. DeBattista is Associate Professor, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.

Dr. Solvason is Assistant Professor, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.

Editor's Note

As primary care practitioners have become more adept at treating depression with antidepressants, psychiatrists are seeing more and more patients who have failed to respond to the usual first line of treatment. Sometimes this is due to a low dose, poor compliance, or both. In other cases, there seems to be a genuine resistance to the antidepressants used.

The authors review the relatively scant literature dealing with strategies for changing medication when the first selective serotonin reuptake inhibitor fails. From this, suggestions are made for the practical management of these difficult and frustrating patients.

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