Zisook S, et al. - Researchers assesses patient baseline features that could aid clinicians in selecting between commonly used next-step treatments for patients with major depressive disorder who do not attain remission from initial treatments. The data of 1,522 Veterans Health Administration patients without a satisfactory response to at least one course of antidepressant treatment from the US Department of Veterans Affairs (VA) Augmentation and Switching Treatments for Improving Depression Outcomes (VAST-D) study was used. The analysis revealed that individuals who were employed, less severely and chronically depressed, less anxious, not experiencing complicated grief symptoms, did not experience childhood adversity, and had better quality of life and positive mental health attained remission more frequently. Specific next-step treatment selections could be done on the bases of age ≥65 years and severe mixed hypomanic symptoms. Among patients aged ≥65 years, higher efficacy of augmentation with aripiprazole than switch to bupropion was noted. For severe mixed hypomanic symptoms, higher efficacy of augmentation with aripiprazole and combination with bupropion was observed than switch to bupropion.