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Table 3 Recommendations for clinical dimensions of major depressive disorder

From: Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental

Dimension First Intention Second Intention
With marked anhedonia SSRI or SNRI α2-antagonist or agomelatine
With marked psychomotor retardation SNRI. SSRI Tricyclic or α2 antagonists
With marked sleep disturbances SSRI or SNRI or α2-antagonist or agomelatine Tricyclic ADT
With atypical features (hyperphagia, hypersomnia) SSRI or SNRI Tricyclic or agomelatine
With psychotic features SNRI in monotherapy or SSRI in combination with an atypical antipsychotic SSRI, tricyclic ADT or α2-antagonist, in monotherapy or in combination with AAP
With anxious features SSRI or SNRI or α2 antagonist Tricyclic ADT
With high suicidal risk SSRI or SNRI or α2 antagonist Tricyclic ADT or potentiation strategies with lithium or AAP
  1. AAP Atypical Antipsychotic, SNRI Dual serotonin and norepinephrine reuptake inhibitors, SSRI Selective serotonin reuptake inhibitors