Beyond the evidence: is there a place for antidepressant combinations in the pharmacotherapy of depression?
Nicholas A Keks, Graham D Burrows, David L Copolov, Richard Newton, Nick Paoletti, Isaac Schweitzer, John Tiller
MEDICAL JOURNAL OF AUSTRALIA | AUSTRALASIAN MED PUBL CO LTD | Published : 2007
Up to 45% of patients with debilitating and potentially lethal depressive illness do not achieve remission with initial drug treatment. Using combinations of antidepressants as an early option for treatment-resistant depression has become increasingly common. Before trying combination therapy, it is essential first to ensure diagnosis is correct, and then to optimise antidepressant monotherapy, using an effective dose for an adequate period. Subsequently, augmentation of antidepressants with lithium and triiodothyronine should be considered, as these strategies are strongly supported by numerous clinical trials. Electroconvulsive therapy is the most effective treatment for severe depression...View full abstract