The Changing Treatment Landscape for Major Depressive Disorder

Leslie Citrome, MD, MPH


October 03, 2022

Leslie Citrome, MD, MPH, looks back at how major depressive disorder (MDD) was managed at the start of his career in order to capture how much has changed. Dr Citrome remembers the days before fluoxetine, when most patients were prescribed tricyclic antidepressants, and how the landscape quickly changed with the introduction of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

As a part of the increasingly complex treatment landscape, Dr Citrome notes the challenges presented by patients — many referred to psychiatric clinicians by primary care physicians — who are treatment-resistant and cannot have their symptoms alleviated by simply increasing the dose.


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