Drugs combinations for treatment-resistant unipolar depression

Abstract

Despite attempts to optimize antidepressant therapy, a substantial number of patients still fail to respond to the antidepressant prescribed. Up to 30% percent of patients with major depression fail to respond to conventional treatment. Another problem with the antidepressant treatment is loss of efficacy or emergence of depressive symptoms despite ongoing antidepressant treatment. That’s why alternative approaches are still required. Augmentation or drug combination treatment is one of these alternative strategies. In this paper, beside major augmentation strategies such as lithium and thyroid hormone augmentation, novel strategies such as pindolol, atypical antipsychotics and psychostimulant augmentation of antidepressant treatment is reviewed in view of the literature.

Keywords

• treatment-resistance, depression, augmentation, drug combination

Tek uçlu dirençli depresyonda kombine ilaç kullanımları

Öz

Uygun antidepresan tedavi almalarına karşın önemli bir oranda depresif hastanın tedavisinde başarısız kalınmaktadır. Majör depresif hastaların yaklaşık %30’u antidepresan tedavilere cevap vermemektedir. Antidepresan tedavilerle ilgili bir diğer önemli sorun ise devam eden tedaviye karşın etkinliğin kaybolması ya da depresif belirtilerin yeniden ortaya çıkmasıdır. Bu nedenlerle alternatif yaklaşımlara gereksinim duyulmaktadır. Güçlendirme veya kombinasyon tedavisi bu alternatif yöntemlerden biridir. Bu yazıda lityum, tiroid hormonu gibi bilinen güçlendirme yöntemlerinin yanı sıra pindolol, atipik antipsikotik ilaçlar ve psikostimülanlarla güçlendirme gibi yeni yöntemler gözden geçirilecektir.

Anahtar Kelimeler

• tedaviye direnç, depresyon, güçlendirme, ilaç kombinasyonu

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