D29 – 4.2 Pharmacologic Treatments for TRD

Pharmacologic Treatments for TRD

Discontinuing current antidepressant therapy and utilizing one of these options:

  • Serotonin-Norepinephrine reuptake inhibitor (SNRI).
    • Duloxetine (40-120 mg oral daily), venlafaxine ER (75-225 mg oral daily), desvenlafaxine (50-100 mg oral daily).
  • Monoamine oxidase inhibitors (MAOIs).
    • Tranylcypromine (30-60 mg oral daily).
  • Esketamine nasal.
    • Dosage range varies depending on induction phase and/or response to treatment.

*It is best practice when discontinuing any medication is to reduce dose over time (taper). Taper length can vary from 2 days to 12 weeks depending on class/type of medication.

(Carlat & Puzantian, 2020)