What this episode covers
A patient can still feel depressed even when an antidepressant has changed something meaningful. This episode looks at how to recognize a partial response, ask what is different in daily life, and use that information to decide whether to give the medication more time, optimize the dose, switch, or consider augmentation.
When a patient says, “I’m still depressed,” how do you tell whether the antidepressant is helping—and what do you do with that information?
Quick Practical Takeaways
- Ask what is actually different. A lower symptom score matters, but so can shorter low periods, easier mornings, better concentration, or getting to work more reliably.
- Check the trial before declaring a failure. Dose, time at that dose, missed doses, and tolerability all affect what you can conclude from an incomplete response.
- Let the response pattern guide the next move. With room to titrate, partial benefit may support optimizing the current medication. Little meaningful benefit after an adequate trial may favor switching. Benefit that persists at an optimized dose may support augmentation.
- Keep the broader picture in view. Side effects, safety, diagnostic uncertainty, and the patient’s priorities may change the usual sequence.
Listen Now
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Use These at Follow-Up
Use the clinical tool to sort the response and the patient worksheet to bring concrete changes into the conversation.
Free clinical tool
Antidepressant Response: Optimize, Switch, or Augment?
A two-page decision tool with a titration flowchart and a quick reference for interpreting no response, partial response, and next steps.
Free patient worksheet
Antidepressant Response Worksheet
A one-page worksheet patients can complete before follow-up to compare what was happening before and now, note side effects or missed doses, and name what they most want help with.
Build the full depression framework
Interpreting one follow-up is only part of depression care. Managing Depression in Primary Care connects diagnosis, medication selection, titration, switching, augmentation, and longer-term decisions in a practical clinical framework with tools you can return to in clinic.