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FIGURE 11–2. Strategies for the treatment of major depression (nonpsychotic).Note. SSRI = selective serotonin reuptake inhibitor (fluoxetine, sertraline, paroxetine, citalopram); BUPSR = bupropion sustained release; NEF = nefazodone; VLFXR = venlafaxine extended release; MRT = mirtazapine; TCA = tricyclic antidepressant; MAOI = monoamine oxidase inhibitor; ECT = electroconvulsive therapy.*Consider TCA/VLF if not tried. **Lithium, thyroid, buspirone. ***Skip if lithium augmentation has already failed.Most studied combination.Source.  Trivedi et al. 2004. Algorithms are revised as new data become available; consult the Texas Implementation of Medication Algorithms (TIMA) Web site (http://www.dshs.state.tx.us/mhprograms/TIMA.shtm) for the most recent versions.

FIGURE 11–3. Strategies for the treatment of bipolar disorder (hypomanic/manic episode).Note. AC = anticonvulsant; AAP = atypical antipsychotic; CONT = continuation treatment; DVP = divalproex; ECT = electroconvulsive therapy; Li = lithium; OLZ = olanzapine; OXC = oxcarbazepine; QTP = quetiapine; RIS = risperidone; TPM = topiramate; VPA = valproate; ZIP = ziprasidone.Source.  Suppes et al. 2001. Algorithms are revised as new data become available; consult the Texas Implementation of Medication Algorithms (TIMA) Web site (http://www.dshs.state.tx.us/mhprograms/TIMA.shtm) for the most recent versions.

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