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. 2014 Dec;26(6):357-9.
doi: 10.11919/j.issn.1002-0829.214152.

When is antidepressant polypharmacy appropriate in the treatment of depression?

Tianmei Si  1 , Ping Wang  1
Affiliations

When is antidepressant polypharmacy appropriate in the treatment of depression?

Tianmei Si et al. Shanghai Arch Psychiatry. 2014 Dec.

Abstract
in English, Chinese

Depression is a serious medical condition that is often only partially improved or completely unchanged after standard treatment with antidepressant medications. Various approaches have been developed to treat this subgroup of individuals with 'treatment-resistant' depression; but many individuals continue to live with chronic depressive symptoms that seriously affect their quality of life and overall functioning. One relatively new strategy is 'antidepressant polypharmacy' - simultaneously administering two or more antidepressant medications. Given the heterogeneity of the etiology of depression, this approach could improve therapeutic outcomes by concurrently activating multiple neurological pathways with different mechanisms of action, but there is also the risk that using multiple antidepressants would increase the prevalence and severity of side effects. Further work is needed to assess the potential benefits and risks of this strategy to managing treatmentresistant depression.

抑郁症是一种严重的精神障碍，单一抗抑郁药 物系统治疗后往往只有部分患者改善，有些患者的症 状可能毫无缓解。尽管针对这一“难治性”抑郁症患 者亚群已经发展出多种不同的治疗方法，但许多患者 仍然带着慢性抑郁症状生活，生活质量和整体功能受 到严重影响。一种相对较新的难治性抑郁症治疗方法 就是“抗抑郁药物联合治疗”——同时用两种或两种 以上的抗抑郁药物治疗。正因为抑郁症不是单一病因 学的疾病，该方法可以通过同时激活不同作用机制的 多种神经通路来提高治疗结果。当然同时使用多种抗 抑郁药物也可能会增加不良反应的发生率及其严重程 度。进一步的研究工作将是评估该难治性抑郁症治疗 方法的潜在益处和风险。

Keywords: adjunctive treatment; antidepressants; depression; multimodal treatment; polypharmacy; treatment-resistant depression.

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References

    1. Millan MJ. On ‘polypharmacy’ and multi-target agents, complementary strategies for improving the treatment of depression: a comparative appraisal. Int J Neuropsychoph. 2014;17(4): 1009–1037.. doi: 10.1017/S1461145712001496. - DOI - PubMed
    1. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11): 1905–1917. - PubMed
    1. Rush AJ, et al. Combining antidepressant medications: a good idea? Am J Psychiatry. 2010;167(3): 241–243. doi: 10.1176/appi.ajp.2009.09121768. - DOI - PubMed
    1. Gelenberg AJ, Freeman MP, Markowitz JC, Rosenbaum JF, Thase ME, Trivedi MH, et al. Practice guideline for the treatment of patients with major depressive disorder,Third Edition. Washinton DC: American Psychiatric Publishing. 2010
    1. Maes M, Libbrecht I, Van Hunsel F, Campens D, Melter HY. Pindolol and mianserin augment the antidepressant activity of fluoxetine in hospitalized major depressed patients, including those with treatment resistance. J Clin Psychopharmacol. 1999;19: 177–182. - PubMed

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