Lisa Harding, MD

With five adjunctive atypical antipsychotics now approved for MDD, tolerability differences do most of the deciding. The panel matches specific side-effect profiles to individual patients and raises when tapering should begin.

Modest efficacy gains from switching push many clinicians toward augmentation instead. The panel weighs guideline thresholds, side-effect-driven medication matching, and the polypharmacy risks that complicate adding a second agent.

Lisa Harding, MD, says ECT, ketamine, TMS, and VNS can work, but evidence on what comes after acute response remains thin.

Generic antidepressant switching has little supporting evidence, and Erin Crown explains why she often chooses early augmentation instead, guided by each patient's risk factors.

Deciding whether to switch medications or build on a partial response shapes every subsequent treatment choice. Dr. Citrome outlines the criteria that separate a true nonresponse from a foundation worth augmenting.

In-person visits let Erin Crown read incongruence between what a patient says and how they present, and one encounter years ago showed her exactly why that matters.

A vague sense of 'blah' is often the last symptom to lift. Dr. Harding and Dr. Citrome examine why anhedonia and disrupted sleep persist longest, and how tracking them closely reveals early warning signs.

A patient's improving score does not always translate into a patient who feels better, and Erin Crown explains how anhedonia and cognitive symptoms account for the gap.

More than half of patients treated for depression don't believe full remission is achievable. The panel explores what success should mean to the patient in front of you, and why patients rarely admit they've stopped taking a medication.

Standardized questionnaires matter, but Erin Crown leans on detailed conversation about a patient's daily routines to catch functional changes that no scale fully captures.

Standardized rating scales define response and remission in clinical trials, but Erin Crown argues real recovery means returning fully to the life a patient had before depression began.

A PHQ-9 score can mislead as easily as it clarifies. The panel unpacks the gap between rating-scale remission and how patients actually experience recovery, using real cases where appearances and scores diverged sharply.

Precision medicine looks different in psychiatry than in oncology. The panel discusses why personalizing MDD care starts with a complete patient history, and how clinical experience, evidence, and patient goals combine to guide treatment.

Explore how clinicians weigh ECT, TMS, ketamine, and vagus nerve stimulation for treatment-resistant depression—balancing speed, access, durability, and patient preference.

An esketamine expert reflects on 7 years of nasal spray use and asks why racemic ketamine faces none of the same rules.

Many symptoms that most impair patients with major depressive disorder go unspoken until treatment starts working, making early recognition and patient-defined goals central to effective care.

Depression's cardinal symptoms are often invisible to the patient reporting them. Dr. Harding and Dr. Citrome examine why diagnosis, not treatment, remains psychiatry's hardest task, and how family observation and screening for bipolar depression change the diagnostic path.

An expert expresses concerns over NRx-100's "expanded access" for ketamine, questioning its safety claims and prioritizing market strategy over patient care.

Here's how embracing a comprehensive, patient-centered approach and staying informed about emerging treatments can help mental health professionals make a difference in the lives of patients with TRD.

Don't miss this session at the APA 2023 Annual Meeting in San Francisco!