Provide optimized antidepressant monotherapy with multiple drugs before considering antidepressant polypharmacy.

• Type of Material: Article
• Authors: Tammy Saah, Emory University; Steven Garlow, Emory University; Mark Rapaport, Emory University
• Language: English
• Date: 2014-12
• Publisher: Shanghai Archives of Psychiatry editorial office
• Publication Version: Final Published Version
• Copyright Statement: © 2014 by Shanghai Municipal Bureau of Publishing
• License: Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.11919/j.issn.1002-0829.214182
• Title of Journal or Parent Work: Shanghai Archives of Psychiatry
• ISSN: 1002-0829
• Volume: 26
• Issue: 6
• Start Page: 360
• End Page: 362
• Grant/Funding Information: No funding was received for preparing this commentary.
• Keywords: polypharmacy; augmentation; major depressive disorder; antidepressants; treatment-resistant depression
• Research Categories: Psychology, Behavioral

Abstract

Many patients with chronic or recurring major depressive disorder have suboptimal responses to the wide range of antidepressant medications available. When confronted with these patients, clinicians may augment the original antidepressant with other medications, including adjunctive treatment with a second or third antidepressant. Although it is a widely-used practice among psychiatrists and primary care physicians in high-income countries, evidence for the benefits of this type of antidepressant polypharmacy is limited. Care should be taken to utilize this approach only after failure of optimized monotherapy with different classes of antidepressants.