Facharzt FMH Psychiatrie Und Psychotherapie Practice Questions - Facharzt FMH Für Psychiatrie Und Psychotherapie Spécialiste FMH En Psychiatrie Et Psychothérapie Exam

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A 42-year-old woman with unipolar major depressive disorder has failed to achieve clinical remission despite sequential 8-week trials of escitalopram (20 mg/day) and venlafaxine extended-release (225 mg/day), both taken with verified therapeutic compliance and confirmed therapeutic plasma levels on therapeutic drug monitoring (TDM). She meets criteria for Treatment-Resistant Depression (TRD). According to Swiss Society of Psychiatry and Psychotherapy (SGPP) and WFSBP guidelines, which evidence-based pharmacological strategy has the highest level of empirical evidence for next-step augmentation?

Switching to a third selective serotonin reuptake inhibitor (e.g., sertraline 100 mg/day) Augmentation with Lithium (target serum trough level 0.6–0.8 mmol/L) or a low-dose second-generation antipsychotic (e.g., aripiprazole) Adding high-dose buspirone (60 mg/day) monotherapy Initiating long-term oral benzodiazepine therapy with clonazepam (2 mg/day)

Correct Answer:

Augmentation with Lithium (target serum trough level 0.6–0.8 mmol/L) or a low-dose second-generation antipsychotic (e.g., aripiprazole)

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