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[Combining antidepressants: a useful strategy for therapy resistant depression?].
Fortschr Neurol Psychiatr. 2009 Jun; 77(6):316-25.FN

Abstract

Various pharmacological strategies have been developed to treat such refractory depression, of which combination therapies with antidepressants are one of the most important. This article reviews both benefits and risks of all known antidepressant combination strategies. The relevant literature was identified by means of a computerized MEDLINE research on the years 1990-2006 and scanning of review articles. The use of antidepressant combinations to overcome refractory depression is a common strategy in practice. Many antidepressants can be usefully combined especially if they engage separate mechanisms of action--like SSRIs with Reboxetine, Bupropion, Mirtazapine and Tricyclics--or on the other hand--Tricyclics with MAO-Inhibitiors. Combination strategies are effective treatment options, however they do have potential safety risks due to pharmacokinetic and pharmacodynamic interactions. Combinations including MAOIs can cause serotonin syndrome, and some SSRIs like Fluoxetine may elevate tricyclic plasma levels with the consequence of an increased risk of toxicity. The distinct knowledge of available antidepressant combination strategies may help to increase response--as well as remission rates in therapy resistant depression. However, further research is urgently needed to determine relative efficacy.

Authors+Show Affiliations

Bezirkskrankenhaus Augsburg, 86156 Augsburg. m.schmauss@bkh-augsburg.deNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

19415584

Citation

Schmauss, M, and T Messer. "[Combining Antidepressants: a Useful Strategy for Therapy Resistant Depression?]." Fortschritte Der Neurologie-Psychiatrie, vol. 77, no. 6, 2009, pp. 316-25.
Schmauss M, Messer T. [Combining antidepressants: a useful strategy for therapy resistant depression?]. Fortschr Neurol Psychiatr. 2009;77(6):316-25.
Schmauss, M., & Messer, T. (2009). [Combining antidepressants: a useful strategy for therapy resistant depression?]. Fortschritte Der Neurologie-Psychiatrie, 77(6), 316-25. https://doi.org/10.1055/s-0028-1109338
Schmauss M, Messer T. [Combining Antidepressants: a Useful Strategy for Therapy Resistant Depression?]. Fortschr Neurol Psychiatr. 2009;77(6):316-25. PubMed PMID: 19415584.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Combining antidepressants: a useful strategy for therapy resistant depression?]. AU - Schmauss,M, AU - Messer,T, Y1 - 2009/05/04/ PY - 2009/5/6/entrez PY - 2009/5/6/pubmed PY - 2009/8/13/medline SP - 316 EP - 25 JF - Fortschritte der Neurologie-Psychiatrie JO - Fortschr Neurol Psychiatr VL - 77 IS - 6 N2 - Various pharmacological strategies have been developed to treat such refractory depression, of which combination therapies with antidepressants are one of the most important. This article reviews both benefits and risks of all known antidepressant combination strategies. The relevant literature was identified by means of a computerized MEDLINE research on the years 1990-2006 and scanning of review articles. The use of antidepressant combinations to overcome refractory depression is a common strategy in practice. Many antidepressants can be usefully combined especially if they engage separate mechanisms of action--like SSRIs with Reboxetine, Bupropion, Mirtazapine and Tricyclics--or on the other hand--Tricyclics with MAO-Inhibitiors. Combination strategies are effective treatment options, however they do have potential safety risks due to pharmacokinetic and pharmacodynamic interactions. Combinations including MAOIs can cause serotonin syndrome, and some SSRIs like Fluoxetine may elevate tricyclic plasma levels with the consequence of an increased risk of toxicity. The distinct knowledge of available antidepressant combination strategies may help to increase response--as well as remission rates in therapy resistant depression. However, further research is urgently needed to determine relative efficacy. SN - 1439-3522 UR - https://www.unboundmedicine.com/medline/citation/19415584/[Combining_antidepressants:_a_useful_strategy_for_therapy_resistant_depression]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0028-1109338 DB - PRIME DP - Unbound Medicine ER -