Pharmacologic and therapeutic strategies in treatment-resistant depression. Augmentation strategies.

Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
CNS spectrums (Impact Factor: 2.71). 04/2009; 14(3 Suppl 4):7-10.
Source: PubMed
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    • "Agents with complementary components of action have a greater chance of controlling both the mood disturbances of depression and other associated symptoms (Millan, 2009). Finally, a wealth of evidence has shown that augmenting SSRIs with agents of other classes (including lithium salts, atypical antipsychotics, buspirone and thyroxine) enhances the therapeutic efficacy of SSRIs (Fava, 2009; Nelson, 2009; Thase, 2009). These improved effects are more than would be expected with dose increases and likely reflect the recruitment of mechanisms complementary to 5-HT reuptake inhibition (Millan, 2009). "
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    ABSTRACT: Effective treatment with antidepressants is currently limited by factors that affect treatment compliance, including delay in onset of therapeutic effects and intolerable side-effects. Recent data suggest that use of antidepressant combinations with different mechanisms of action may be a better first-line strategy prior to augmentation with other drug classes. The rationale for this approach is that combining multiple pharmacological actions affecting multiple monoamine targets produces greater efficacy. Several new multi-modal compounds are in development and early results for the most advanced agents indicate shorter onset of therapeutic effects and improved tolerability. By modulating multiple receptors and transmitter systems, it is hoped that these new agents may also treat some of the associated symptoms of major depressive disorder, such as anxiety and cognitive dysfunction.
    The International Journal of Neuropsychopharmacology 01/2013; 16(6):1-10. DOI:10.1017/S1461145712001605 · 4.01 Impact Factor

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