Combination/augmentation strategies for improving the treatment of depression

Depression is a common and debilitating condition, with considerable impact for depressed individuals and a heavy burden for society. In spite of its prevalence, depression is underrecognized and under- or inappropriately treated. In spite of the large number of antidepressants available at the present time, they are far from ideal and all show a similar slow, and frequently, incomplete response. Thus, the need for new and better compounds is as urgent and compelling as ever. While waiting for the panacea of future antidepressants, clinicians have developed a variety of associations of several antidepressants or an antidepressant with a second different agent. This article reviews the various strategies adopted by clinicians in the hope of increasing the response rate of current antidepressants to obtain full remission and/or to overcome treatment-resistant depression.