Going Beyond Antidepressant Monotherapy for Incomplete Response in Nonpsychotic Late-Life Depression: A Critical Review

Many older adults with major depressive disorder (MDD) do not respond to antidepressant monotherapy. Although there are evidence-based treatment options to support treatment beyond monotherapy for adults, the evidence for such strategies, specifically in late-life MDD, is relatively scarce. This review examines the published data describing strategies for antidepressant augmentation or acceleration studied specifically in older adults, including lithium, stimulants, and second-generation antipsychotics. In addition, the authors suggest strategies for future research, such as study of specific agents, refining understanding of the impact of medical or cognitive comorbidity in late-life depression, and comparative effectiveness to examine methods already used in clinical practice.