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Related Concept Videos

Antidepressant Drugs: MAOIs and Other Agents01:23

Antidepressant Drugs: MAOIs and Other Agents

Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
Treatment Strategies for Psychological Disorders01:24

Treatment Strategies for Psychological Disorders

Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Drug Therapy01:28

Drug Therapy

The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Antidepressant Drugs: Overview01:25

Antidepressant Drugs: Overview

Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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Published on: January 7, 2019

Augmentation and combination strategies for complicated depression.

Maurizio Fava1

  • 1Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, USA.

The Journal of Clinical Psychiatry
|December 25, 2009
PubMed
Summary

Many patients with depression need more than one medication. Augmentation or combination therapies show promise for treatment-resistant depression, but more research is needed to guide optimal strategies.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Major depressive disorder (MDD) affects a significant portion of the population.
  • First-line antidepressant monotherapy is often insufficient, with approximately 50% of patients experiencing inadequate response.
  • Treatment-resistant depression (TRD) necessitates exploring alternative therapeutic approaches.

Purpose of the Study:

  • To review and evaluate augmentation and combination strategies for enhancing antidepressant treatment response in patients with depression.
  • To assess the safety and efficacy of nonantidepressant augmentation and antidepressant combination therapies.
  • To identify gaps in current research and suggest future directions for TRD management.

Main Methods:

  • Literature review of augmentation and combination strategies in antidepressant therapy.
  • Analysis of existing controlled studies on treatment enhancement for depression.
  • Synthesis of data regarding the safety and effectiveness of various therapeutic combinations.

Main Results:

  • Augmentation with nonantidepressant agents and combination with other antidepressants are viable strategies for improving treatment response.
  • These strategies appear relatively safe and effective for managing depression.
  • Evidence suggests potential benefits for patients not responding to initial monotherapy.

Conclusions:

  • Augmentation and combination therapies represent important options for patients with suboptimal response to initial antidepressant monotherapy.
  • Further controlled studies are required to directly compare these strategies and inform clinical decision-making.
  • Research is needed to determine optimal treatment durations for combination or augmentation in TRD.