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Q Should I consider using lithium (Eskalith and others) to augment antidepressants in my patients with treatment-resistant depression?
A Yes. Lithium is the most well-studied augmentation for treatment-refractory depression in double-blind, placebo-controlled studies. In arecentmeta-analysis investigating the efficacy of lithium augmentation of conventional antidepressants, all placebo-controlled trials of lithium augmentation in refractory depression were assessed. Most patients were taking selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), or tricyclic antidepressants such as desipramine (Norpramin).
Only double-blind studies that …