This protocol addresses patients with Wilson's disease who are experiencing depression and have not achieved improvement or resolution of depressive symptoms with first-line SSRI therapy.
An SSRI (citalopram, escitalopram, or sertraline) was trialled as first-line treatment for depression in Wilson's disease. The target — improvement or resolution of depressive symptoms — was not achieved, indicating the need for escalation to a second-line approach.
Second-line management moves beyond SSRIs to include antidepressant agents from the tricyclic (TCA) and serotonin-norepinephrine reuptake inhibitor (SNRI) classes, among other options. The full structured regimen — agent selection, clinical criteria, and sequencing — is available in the complete protocol.
Improvement or resolution of depressive symptoms.