Treatment of depression: antidepressant monotherapy and combination therapy

We investigated the use of antidepressants in the treatment of depression. According to our data, antidepressants are most commonly used alone (85%); however, the prevalence of antidepressant monotherapy decreases as the physician's impression of patient severity increases (92% mild, 84% moderate, 73% severe). Psychiatrists are more likely to use antidepressant combinations than primary care physicians (32% vs. 8%). With respect to combination therapy, the most likely agent to be used in combination with an antidepressant in the treatment of depression was another antidepressant (6.4%); followed by anxiety agents (5.2%), antipsychotics (2.4%), and mood stabilizers and sleep aids (1.2% each). An expert commentary on the data is provided.