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Drugs combinations for treatment-resistant unipolar depression

Year 2013, Volume: 3 Issue: 5, 0 - 0, 01.05.2013

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.

References

  • Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006;354:1243–52.
  • Crossley NA, Bauer M. Acceleration and augmentation of antidepressants with lithium for depressive disorders: two metaanalyses of randomized, placebo-controlled trials. J Clin Psychiatry 2007;68:935–40.
  • Nierenberg AA, Fava M, Trivedi MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR-D report. Am J Psychiatry. 2006;163:1519–30.
  • Carvalho AF, Cavalcante JL, Castelo MS, Lima MC. Augmentation strategies for treatment-resistant depression: a literature review. J Clin Pharm Ther 2007;32:415–28.
  • Altshuler LL, Bauer M, Frye MA, et al. Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. Am J Psychiatry 2001;158:1617–22.
  • Joffe RT, Sokolov ST, Levitt AJ. Lithium and triiodothyronine augmentation of antidepressants. Can J Psychiatry 2006;51:791–3.
  • Geretsegger C, Bitterlich W, Stelzig R, et al. Paroxetine with pindolol augmentation: a double-blind, randomized, placebo controlled study in depressed in-patients. Eur Neuropsychopharmacol 2008;18:141–6.
  • Landen M, Bjorling G, Agren H, Fahlen T. A randomized, double blind, placebo-controlled trial of buspirone in combination with an SSRI in patients with treatment-refractory depression. J Clin Psychiatry 1998;59:664–8.
  • Shelton RC, Papakostas GI. Augmentation of antidepressants with atypical antipsychotics for treatment-resistant major depressive disorder. Acta Psychiatr Scand 2008;117:253–9.
  • Papakostas GI, Shelton RC, Smith J, Fava M. Augmentation of antidepressants with atypical antipsychotic medications for treatmentresistant major depressive disorder: a meta-analysis. J Clin Psychiatry 2007;68:826–31.
  • Marcus RN, McQuade RD, William C, et al. The efficacy and safety of aripiprazole as adjunctive treatment in major depressive disorder: a second multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychopharmacol 2008;28:243–5.
  • DeBattista C, Doghramji K, Menza MA, et al. Adjunct modafinil for the shortterm treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study. J Clin Psychiatry 2003;64:1057–64.
  • Fava M, Thase ME, DeBattista C, et al. Modafinil augmentation of selective serotonin reuptake inhibitor therapy in MDD partial responders with persistent fatigue and sleepiness. Ann Clin Psychiatry 2007; 19:153–9.
  • Patkar AA, Masand PS, Pae CU, et al. A randomized, double blind, placebo controlled trial of augmentation with an extended release formulation of methylphenidate in outpatients with treatment-resistant depression. J Clin Psychopharmacol 2006;26:653–6.
  • Ros S, Agüera L, de la Gandara J, Emilio Rojo J, de Pedro JM. Potentiation strategies for treatment-resistant depression. Acta Psychiatr Scand 2005;112(Suppl.428):14-24.
  • Santos MA, Rocha FL, Hara C. Efficacy and safety of antidepressant augmentation with lamotrigine in patients with treatment resistant depression: a randomized, placebo-controlled, double-blind study. Prim Care Companion J Clin Psychiatry 2008;10:187–90.
  • Fleck MP, Horwath H. Pharmacologic management of difficult to- treat depression in clinical practice. Psychiatric Services 2005;56:1005-11.
  • Keitner GI, Mansfield AK. Management of treatment-resistant depression. Psychiatr Clin North Am 2012; 35:249-65.
  • Mathys M, Mitchell BG. Targeting treatment-resistant depression. J Pharm Pract 2011;24:520-33.
  • Thase ME. Antidepressant combinations: widely used, but far from empirically validated. Can J Psychiatry 2011;56:317-23.
  • McGrath PJ, Stewart JW, Fava M, et al. Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR-D report. Am J Psychiatry. 2006;163:1531–41.
  • Dodd S, Horgan D, Malhi GS, Berk M. To combine or not to combine? A literature review of antidepressant combination therapy. J Affect Disord 2005;89:1-11.

Tek uçlu dirençli depresyonda kombine ilaç kullanımları

Year 2013, Volume: 3 Issue: 5, 0 - 0, 01.05.2013

Abstract

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.

References

  • Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006;354:1243–52.
  • Crossley NA, Bauer M. Acceleration and augmentation of antidepressants with lithium for depressive disorders: two metaanalyses of randomized, placebo-controlled trials. J Clin Psychiatry 2007;68:935–40.
  • Nierenberg AA, Fava M, Trivedi MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR-D report. Am J Psychiatry. 2006;163:1519–30.
  • Carvalho AF, Cavalcante JL, Castelo MS, Lima MC. Augmentation strategies for treatment-resistant depression: a literature review. J Clin Pharm Ther 2007;32:415–28.
  • Altshuler LL, Bauer M, Frye MA, et al. Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. Am J Psychiatry 2001;158:1617–22.
  • Joffe RT, Sokolov ST, Levitt AJ. Lithium and triiodothyronine augmentation of antidepressants. Can J Psychiatry 2006;51:791–3.
  • Geretsegger C, Bitterlich W, Stelzig R, et al. Paroxetine with pindolol augmentation: a double-blind, randomized, placebo controlled study in depressed in-patients. Eur Neuropsychopharmacol 2008;18:141–6.
  • Landen M, Bjorling G, Agren H, Fahlen T. A randomized, double blind, placebo-controlled trial of buspirone in combination with an SSRI in patients with treatment-refractory depression. J Clin Psychiatry 1998;59:664–8.
  • Shelton RC, Papakostas GI. Augmentation of antidepressants with atypical antipsychotics for treatment-resistant major depressive disorder. Acta Psychiatr Scand 2008;117:253–9.
  • Papakostas GI, Shelton RC, Smith J, Fava M. Augmentation of antidepressants with atypical antipsychotic medications for treatmentresistant major depressive disorder: a meta-analysis. J Clin Psychiatry 2007;68:826–31.
  • Marcus RN, McQuade RD, William C, et al. The efficacy and safety of aripiprazole as adjunctive treatment in major depressive disorder: a second multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychopharmacol 2008;28:243–5.
  • DeBattista C, Doghramji K, Menza MA, et al. Adjunct modafinil for the shortterm treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study. J Clin Psychiatry 2003;64:1057–64.
  • Fava M, Thase ME, DeBattista C, et al. Modafinil augmentation of selective serotonin reuptake inhibitor therapy in MDD partial responders with persistent fatigue and sleepiness. Ann Clin Psychiatry 2007; 19:153–9.
  • Patkar AA, Masand PS, Pae CU, et al. A randomized, double blind, placebo controlled trial of augmentation with an extended release formulation of methylphenidate in outpatients with treatment-resistant depression. J Clin Psychopharmacol 2006;26:653–6.
  • Ros S, Agüera L, de la Gandara J, Emilio Rojo J, de Pedro JM. Potentiation strategies for treatment-resistant depression. Acta Psychiatr Scand 2005;112(Suppl.428):14-24.
  • Santos MA, Rocha FL, Hara C. Efficacy and safety of antidepressant augmentation with lamotrigine in patients with treatment resistant depression: a randomized, placebo-controlled, double-blind study. Prim Care Companion J Clin Psychiatry 2008;10:187–90.
  • Fleck MP, Horwath H. Pharmacologic management of difficult to- treat depression in clinical practice. Psychiatric Services 2005;56:1005-11.
  • Keitner GI, Mansfield AK. Management of treatment-resistant depression. Psychiatr Clin North Am 2012; 35:249-65.
  • Mathys M, Mitchell BG. Targeting treatment-resistant depression. J Pharm Pract 2011;24:520-33.
  • Thase ME. Antidepressant combinations: widely used, but far from empirically validated. Can J Psychiatry 2011;56:317-23.
  • McGrath PJ, Stewart JW, Fava M, et al. Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR-D report. Am J Psychiatry. 2006;163:1531–41.
  • Dodd S, Horgan D, Malhi GS, Berk M. To combine or not to combine? A literature review of antidepressant combination therapy. J Affect Disord 2005;89:1-11.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Özcan Uzun This is me

Publication Date May 1, 2013
Published in Issue Year 2013 Volume: 3 Issue: 5

Cite

APA Uzun, Ö. (2013). Tek uçlu dirençli depresyonda kombine ilaç kullanımları. Journal of Mood Disorders, 3(5).
AMA Uzun Ö. Tek uçlu dirençli depresyonda kombine ilaç kullanımları. Journal of Mood Disorders. May 2013;3(5).
Chicago Uzun, Özcan. “Tek uçlu dirençli Depresyonda Kombine Ilaç kullanımları”. Journal of Mood Disorders 3, no. 5 (May 2013).
EndNote Uzun Ö (May 1, 2013) Tek uçlu dirençli depresyonda kombine ilaç kullanımları. Journal of Mood Disorders 3 5
IEEE Ö. Uzun, “Tek uçlu dirençli depresyonda kombine ilaç kullanımları”, Journal of Mood Disorders, vol. 3, no. 5, 2013.
ISNAD Uzun, Özcan. “Tek uçlu dirençli Depresyonda Kombine Ilaç kullanımları”. Journal of Mood Disorders 3/5 (May 2013).
JAMA Uzun Ö. Tek uçlu dirençli depresyonda kombine ilaç kullanımları. Journal of Mood Disorders. 2013;3.
MLA Uzun, Özcan. “Tek uçlu dirençli Depresyonda Kombine Ilaç kullanımları”. Journal of Mood Disorders, vol. 3, no. 5, 2013.
Vancouver Uzun Ö. Tek uçlu dirençli depresyonda kombine ilaç kullanımları. Journal of Mood Disorders. 2013;3(5).