Next-Step Treatment Options for Treatment-Resistant Depression: Insights From the Mayo Clinic Depression Center Panel.
The Journal of clinical psychiatry January 21, 2026 Matheus G Marques, Aysegul Özerdem, Simon Kung et al. 1 citation
For treatment-resistant depression (TRD), a panel of 10 psychiatrists reached strong consensus on recommending augmentation with second-generation antipsychotics, transcranial magnetic stimulation, and ketamine/esketamine as next-step treatments after three failed antidepressant trials. Treatment preferences shifted to include nonaugmentative antidepressants and electroconvulsive therapy depending on patient characteristics such as metabolic disease and age. The findings underscore the importance of tailoring TRD treatment strategies to individual patient factors beyond conventional guideline tiers.