An audit to compare the efficacy of treatment (as indicated by discharge rates and reduction in suicidality) among patients with refractory depression in a Bedfordshire Community Mental Health Team receiving augmentation therapy with either mirtazepine or atypical antipsychotics.

In recent years, there has been particular interest in the use of augmentation. Potential augmentation regimes include the addition of atypical antipsychotics (e.g. risperidone/olanzapine) or other antidepressants (e.g. mirtazepine). The purpose of this audit was to compare patient outcomes between groups receiving different augmentation strategies. Overall we found that augmentation with mirtazepine resulted in better outcomes in terms of both discharge rates and in terms of reduction in suicidality than augmentation with atypical antipsychotics.