when patients don't respond fully to their antidepressant

    What can you do when patients don't respond fully to their antidepressant?

    Lithium has been used for years to boost the efficacy of antidepressants. Add lithium 600 to 900 mg/day...monitor lithium levels to avoid toxicity.

    Thyroid is also useful sometimes. Cytomel (liothyronine, T3) works better than levothyroxine (T4) in euthyroid patients. Give Cytomel 25 to 50 mcg/day and watch for symptoms of hyperthyroidism. This can be delicate...and should be done only by an expert.

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