Question

scenario: a patient with depression is not responding to ssris. the clinician considers augmenting with a medication that modulates norepinephrine. question: which medication is appropriate for augmentation? bupropion. lamotrigine. valproate. lithium.

Explanation:

To determine the appropriate medication for augmenting depression treatment (when SSRIs fail) and modulating norepinephrine, we analyze each option:

• Bupropion: It is a medication that acts on norepinephrine (and dopamine) systems, making it suitable for augmenting depression treatment by modulating norepinephrine.
• Lamotrigine: Primarily used for epilepsy and bipolar disorder, its mechanism is related to glutamate modulation, not norepinephrine.
• Valproate: Used for bipolar disorder and seizures, it works on GABA and other mechanisms, not primarily norepinephrine modulation.
• Lithium: Used for bipolar disorder, its mechanism is not centered around norepinephrine modulation.

So, Bupropion is the correct choice as it modulates norepinephrine and is used for augmenting depression treatment.

Answer:

A. Bupropion