Systematic Review of Lithium Augmentation in Depression Resistant to at Least 2 Antidepressants

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To the Editor: Refractory depression is common inclinical practice. At least 30% of patients fail to respond toinitial antidepressant therapy.¹ In patients who have failed 1course of antidepressants, there is evidence from 9 randomizedcontrolled trials suggesting that approximately 50% oftreatment-refractory patients do respond to lithium augmentationcompared with placebo (p < .001).²