Strategies for the treatment of refractory depression include “switching” and “augmentation”. in recent years, there has been particular interest in the use of augmentation.

The purpose of this audit was to define patient factors among people receiving augmentation therapy with either mirtazepine or atypical antipsychotics.

We searched an anonymised database of patients and identified those receiving augmentation with mirtazepine (group A), atypical antipsychotics (group B) or both (group C). for each of the three groups we recorded the following factors: (1) age, (2) sex, (3) suicidal ideation, (4) alcohol problems, (5) drug problems, (6) domestic problems (e.g. debts, child abuse & domestic violence) (7) psychotic symptoms and (8) co-existing physical diagnoses.

Group B spanned a wider range of ages than either of the other two groups. Group A contained the highest proportion of patients with suicidal ideation than either. Alcohol problems were most common in group A, drug problems most common in group B and domestic problems most common in group C. Perhaps unsurprisingly psychotic symptoms were present in a relatively high percentage of patients in group B. there was little difference in physical co-morbidities between the three groups.

The audit reveals some interesting differences in patient factors between the three groups. Knowledge about such differences is useful in practical terms because it allows doctors in the BCMHT to target therapy for different patients towards their specific needs.