Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression
Before switching my antidepressant, is adding a low dose of aripiprazole to what I already take a better next step for me?
Top of the evidence hierarchy, independently funded. how we score evidence
In 619 adults aged 60 or older with treatment-resistant depression (the OPTIMUM trial), adding aripiprazole to the current antidepressant improved well-being more than switching to bupropion (a 4.83- vs 2.04-point gain over 10 weeks) and led to remission in 28.9% of the aripiprazole group.
Worth asking
Before switching my antidepressant, is adding a low dose of aripiprazole to what I already take a better next step for me?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Schizophrenia (adults and adolescents 13-17)
- Bipolar I disorder, acute and maintenance treatment of manic and mixed episodes, monotherapy or adjunct to lithium/valproate (adults and ages 10-17)
- Adjunctive treatment of major depressive disorder (adults)
- Irritability associated with autistic disorder (ages 6-17)
- Tourette's disorder (ages 6-18)
- Agitation associated with schizophrenia or bipolar mania (injection, adults)
Source
Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression — Lenze EJ, et al. (2023)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1056/NEJMoa2204462
DOI: 10.1056/NEJMoa2204462
How this was scored
- Study design
- Randomised controlled trial
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 619
- Preregistered
- Yes
- Conflicts disclosed
- No
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 87 out of 100 on our published rubric. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression — Lenze EJ, et al. (2023). Published in: Top-tier peer-reviewed journal. DOI: 10.1056/NEJMoa2204462. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Randomised controlled trial. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is aripiprazole (Abilify), abilify FDA approved?
Yes — FDA approved for Schizophrenia (adults and adolescents 13-17), Bipolar I disorder, acute and maintenance treatment of manic and mixed episodes, monotherapy or adjunct to lithium/valproate (adults and ages 10-17), Adjunctive treatment of major depressive disorder (adults), Irritability associated with autistic disorder (ages 6-17), Tourette's disorder (ages 6-18), Agitation associated with schizophrenia or bipolar mania (injection, adults). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.