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Augmentation strategies for treatment-resistant depression: a literature review.
J Clin Pharm Ther 2007; 32(5):415-28JC

Abstract

BACKGROUND

The large majority of depressed patients fail to remit on the first antidepressant prescribed. These patients with residual symptoms have higher relapse rates and poorer outcomes than those who remit. Treatment-resistant depression (TRD) is a therapeutic challenge for the clinician. Augmentation pharmacotherapy refers to the addition of drugs that are not standard antidepressants in order to enhance the effect of a classical antidepressant drug. The aim of this paper was to review the available evidence on the various augmenting agents that have been tested for efficacy in TRD.

METHODS

Electronic databases and relevant textbooks were searched and the information retrieved was integrated in this review.

RESULTS

Although augmentation strategies have been tested with various pharmacological agents, there are few controlled studies published. Lithium, triiodothyronine (T3), buspirone and pindolol have been most widely studied. Other agents include dopaminergic agents, atypical antipsychotics, psychostimulants, benzodiazepines/hypnotics, hormones and anticonvulsants.

CONCLUSION

The augmentation therapy with the best evidence was the lithium-antidepressant combination, especially in patients not responding to tricyclic agents. However, good results have also been reported with augmentation strategies involving T3 and buspirone.

Authors+Show Affiliations

Department of Medicine, Psychiatry Outpatient Clinics, Federal University of Ceará, Fortaleza, CE, Brazil. andrefc7@terra.com.brNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17875106

Citation

Carvalho, A F., et al. "Augmentation Strategies for Treatment-resistant Depression: a Literature Review." Journal of Clinical Pharmacy and Therapeutics, vol. 32, no. 5, 2007, pp. 415-28.
Carvalho AF, Cavalcante JL, Castelo MS, et al. Augmentation strategies for treatment-resistant depression: a literature review. J Clin Pharm Ther. 2007;32(5):415-28.
Carvalho, A. F., Cavalcante, J. L., Castelo, M. S., & Lima, M. C. (2007). Augmentation strategies for treatment-resistant depression: a literature review. Journal of Clinical Pharmacy and Therapeutics, 32(5), pp. 415-28.
Carvalho AF, et al. Augmentation Strategies for Treatment-resistant Depression: a Literature Review. J Clin Pharm Ther. 2007;32(5):415-28. PubMed PMID: 17875106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Augmentation strategies for treatment-resistant depression: a literature review. AU - Carvalho,A F, AU - Cavalcante,J L, AU - Castelo,M S, AU - Lima,M C O, PY - 2007/9/19/pubmed PY - 2007/12/8/medline PY - 2007/9/19/entrez SP - 415 EP - 28 JF - Journal of clinical pharmacy and therapeutics JO - J Clin Pharm Ther VL - 32 IS - 5 N2 - BACKGROUND: The large majority of depressed patients fail to remit on the first antidepressant prescribed. These patients with residual symptoms have higher relapse rates and poorer outcomes than those who remit. Treatment-resistant depression (TRD) is a therapeutic challenge for the clinician. Augmentation pharmacotherapy refers to the addition of drugs that are not standard antidepressants in order to enhance the effect of a classical antidepressant drug. The aim of this paper was to review the available evidence on the various augmenting agents that have been tested for efficacy in TRD. METHODS: Electronic databases and relevant textbooks were searched and the information retrieved was integrated in this review. RESULTS: Although augmentation strategies have been tested with various pharmacological agents, there are few controlled studies published. Lithium, triiodothyronine (T3), buspirone and pindolol have been most widely studied. Other agents include dopaminergic agents, atypical antipsychotics, psychostimulants, benzodiazepines/hypnotics, hormones and anticonvulsants. CONCLUSION: The augmentation therapy with the best evidence was the lithium-antidepressant combination, especially in patients not responding to tricyclic agents. However, good results have also been reported with augmentation strategies involving T3 and buspirone. SN - 0269-4727 UR - https://www.unboundmedicine.com/medline/citation/17875106/Augmentation_strategies_for_treatment_resistant_depression:_a_literature_review_ L2 - https://doi.org/10.1111/j.1365-2710.2007.00846.x DB - PRIME DP - Unbound Medicine ER -