intermediatearipiprazoleaugmentationakathisiaBarnes Akathisia Rating Scaletreatment-resistant depressionvenlafaxineextrapyramidal side effects
A 47-year-old female with treatment-resistant major depressive disorder has been taking venlafaxine 225 mg daily for four months with only partial response, with her PHQ-9 decreasing from 24 to 16. Six weeks ago, the PMHNP augmented with aripiprazole 2 mg daily. At today's visit, her PHQ-9 is 11 and she reports improved energy, better concentration, and less persistent sadness. However, she describes new-onset restlessness, an inability to sit still during meetings at work, and a compulsive need to pace in the evenings. She denies anxiety or worsening mood. The PMHNP is evaluating the augmentation outcome. Which of the following best represents the appropriate evaluation?