title: Switching antidepressant class does not improve response or remission in treatment-resistant depression.
abstract: OBJECTIVE
  The management of treatment-resistant depression is a much debated issue. In particular, the evidence supporting the commonly suggested sequential use of antidepressants from 2 different pharmacological classes is weak. This retrospective study was undertaken to investigate whether there is a better response in nonresponders switched to a different class of antidepressants (across-class) compared with nonresponders switched to an antidepressant from the same class (within-class).
  
  
  METHODS
  Three hundred forty patients with primary major depressive disorder were recruited in the context of a European multicenter project. Subjects whose current depressive episode had failed to respond to a first antidepressant trial of adequate dose and duration were included.
  
  
  RESULTS
  There was no significant difference in response or remission rates between the across-class and within-class groups after controlling for possible confounders.
  
  
  CONCLUSIONS
  In depressed nonresponders to a previous antidepressant treatment, switching to a different class of antidepressants was not associated with a better response or remission rate.
authors.affiliation: Laboratoire de Psychologie Médicale, Université Libre de Bruxelles, and Centre Européen de Psychologie Médicale-PsyPluriel, Brussels, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calati
authors.forename: Pierre
authors.initials: P
authors.lastname: Oswald
authors.forename: Isabelle
authors.initials: I
authors.lastname: Massat
authors.forename: Anastasios
authors.initials: A
authors.lastname: Konstantinidis
authors.forename: Sylvie
authors.initials: S
authors.lastname: Linotte
authors.forename: Joseph
authors.initials: J
authors.lastname: Bollen
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Yves
authors.initials: Y
authors.lastname: Lecrubier
authors.forename: Stuart
authors.initials: S
authors.lastname: Montgomery
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000145:classification* / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D057915:Drug Substitution / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents