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Augmentation therapy should be considered in patients who do not have a complete response.

Drugs to consider for use in augmentation therapy include benzodiazepines, buspirone, beta blockers, tricyclic antidepressants, and valproate sodium.

There aren't many well-controlled studies on the effectiveness of different treatments for concurrent depression and insomnia.While most patients have a favorable response to SSRI therapy, 30 percent will not be able to tolerate these medications or will have an unfavorable or incomplete response.1 Eight strategies to manage patients who have not tolerated initial therapy or who have had an unsatisfactory response to it are presented here.3 The initial activating effects of SSRIs and tricyclic antidepressants (TCAs) can be especially troubling.4 As a result, many patients abandon SSRI therapy before they experience any benefits.Following are several strategies to help patients overcome resistance to therapy.However, people with insomnia are more likely to develop depressive and anxiety disorders.People with depression often have severe sleep disturbance, and they respond more slowly to treatment than other patients with sleep disorders.