Some patients being treated for recurrent major depression experience a
return of depressive symptoms despite a constant maintenance dose of an
antidepressant, a phenomenon known as breakthrough depression. A total of
145 psychiatrists who were members of the Massachusetts Psychiatric Society
responded to a survey about intervention in hypothetical cases of
breakthrough depression if the patient was taking either 20 mg of
fluoxetine, 100 mg of sertraline, 100 mg of nortriptyline, or 40 mg of
fluoxetine. For all drugs and dosages, the most popular choice was
increasing the dosage, followed by augmenting with lithium or another
antidepressant or changing to a different drug.
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