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Table 8Monotherapy versus combined therapy studies showing the comparison and treatment interventions grouped by type of intervention

StudyMonotherapyCombined Therapy
Licht,119 2002Sertraline + Placebo
Sertraline (higher dose) + Placebo
Sertraline + Mianserin
Altamura,82,83 2008SSRI + Placebo (saline)SSRI + Citalopram (intravenous)
Add nonSSRI Antidepressant
Altamura,82,83 2008SSRI + Placebo (saline)SSRI + Clomipramine (intravenous)
Trivedi,113 2006
Rush,44 2006*
Thase,110 2007*
Switching to new monotherapy (Buproprion/Venlaxfine/Sertraline/CBT)Citalopram + Buproprion
Fava,118 2002Fluoxetine + PlaceboFluoxetine + Desipramine
Fluoxetine + Lithium
Fava,98 1994FluoxetineFluoxetine + Desipramine
Fluoxetine + Lithium
Add Augmenting Agent
Preskorn,80 2008Paroxetine + PlaceboParoxetine + CP-101606
George,84 2008Current SSRI +placeboCurrent SSRI + Mecamylamine Hydrochloride
Michelson,87,101,132 2007Sertraline + PlaceboSertraline + Atomoxetine
Shapira,89 2006SSRI (Fluoxetine/Fluvoxamine/Paroxetine) + PlaceboCurrent SSRI + Phenytoin
Seidman,91 2005SSRI + Placebo injectionCurrent SSRI + Testosterone injection
Berman,109 2007
Marcus,105,131 2008
Switched to new SSRI
Escilatopram/Fluoxetine/Sertraline/Venlafaxine + Placebo
Switched to new SSRI (Escilatopram/Fluoxetine/Sertraline/Venlafaxine) + Aripiprazole
Fava,114 2005SSRI + placeboSSRI + Modafinil
Nemets,123 1999SSRI + placebo (glucose)SSRI + Inositiol
Dunner,86 2007SertralineSertraline + Ziprasidone 60mg/d
Sertraline + Ziprasidone 80mg/d
Appelberg,120 2001SSRI + placeboSSRI + Buspirone
Landén,97 1998
Landén,92 2005
Landén,130 1999
Citalopram or ParoxetineCitalopram or Paroxetine + Buspirone
Rush,44 2006
Trivedi,113 2006
Thase,110 2007
Switching to new monotherapy (Sertraline/Venlafaxine/Buproprion/CBT)Citalopram + Buspirone
Licht,119 2002Sertraline Dose 1 + Placebo
Sertraline Dose 2 + Placebo
Sertraline + Mianserin
Ferreri,121 2001FluoxetineFluoxetine + Mianserin
Baumann,124 1996Citalopram + PlaceboCitalopram + Lithium
Bondolfi,112 2006ParoxetineParoxetine + Lithium
Switch to Venlaxafine
Fava,118 2002Fluoxetine + PlaceboFluoxetine + Lithium
Fluoxetine + Desipramine
Fava,98 1994FluoxetineFluoxetine + Lithium
Fluoxetine + Desipramine
Atypical Anti-psychotics
Thase,88 2007Fluoxetine
Fluoxetine + Olanzapine
Shelton,122 2001Olanzapine + Placebo
Fluoxetine + Placebo
Fluoxetine + Olanzapine
Keitner,95 2009SSRI + Risperidone
Mahmoud,108 2007SSRI + PlaceboSSRI + Risperidone
Bauer134,188 2010Any SSRI + PlaceboAny SSRI + Quetiapine XR 150 mg
Any SSRI + Quetiapine XR 300 mg
Perry,93 2004Fluoxetine/Setraline/Paroxetine + placebo (lactose powder)Fluoxetine/Setraline/Paroxetine + Pindolol
Sokolski,96 2004Paroxetine + PlaceboParoxetine + Pindolol
Adding Non-pharmacological Treatment
Wiles,94 2008Any SSRISSRI + CBT
Carta,127 2008Any SSRISSRI + Exercise
Lynch,128 2007Paroxetine/Sertraline/FluoxetineSSRI + DBT
Thase,110 2007
Rush,44 2006
Trivedi,113 2006
Switching to new monotherapy (Sertraline/Venlaxfine/Buproprion/CBT)Citalopram + CBT
Reynolds133,135,137 2010Increase Escitalopram dose + EducationIncrease Escitalopram dose + Education + Interpersonal Therapy

CBT = cognitive behavioral therapy; DBT = dialectical behavior therapy; SSRI = selective serotonin reuptake inhibitors


Indicates that comparison arm is not the SSRI prior to the switch.

Indicates that comparison arm is not the SSRI prior to the switch.

From: Results

Cover of Treatment for Depression After Unsatisfactory Response to SSRIs
Treatment for Depression After Unsatisfactory Response to SSRIs [Internet].
Comparative Effectiveness Reviews, No. 62.
Santaguida PL, MacQueen G, Keshavarz H, et al.

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