Antidepressant combination for major depression in incomplete responders—a systematic review

Rocha, Fábio Lopes; Fuzikawa, Cíntia; Riera, Rachel; Ramos, Melissa Guarieiro; Hara, Cláudia

doi:10.1016/j.jad.2012.04.048

Cited by 23 publications

(16 citation statements)

References 24 publications

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“…Hence, multitarget (2 targets) or multimodal (2 targets from different target classes [12]) approaches that involve additive or synergistic effects of selected biological targets may be an attractive strategy for refining and improving efficacy and/or tolerability of currently used antidepressants. These ideas have been extensively discussed in the literature by several research groups [13][14][15][16] and are an overarching theme for this section. The authors wish to highlight in particular the very comprehensive reviews by Millan on this topic [16][17][18][19].…”

Section: Refining and Expanding Monoaminergic Mechanisms Beyond Ssrismentioning

confidence: 99%

Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs

Dale

Bang‐Andersen

Sanchéz

2015

Biochemical Pharmacology

201

108

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The monoamine hypothesis has been the prevailing hypothesis of depression over the last several decades. It states that depression is associated with reduced monoamine function. Hence efforts to increase monoamine transmission by inhibiting serotonin (5-HT) and norepinephrine (NE) transporters has been a central theme in depression research since the 1960s. The selective 5-HT reuptake inhibitors (SSRIs) and 5-HT and NE reuptake inhibitors (SNRIs) that have emerged from this line of research are currently first line treatment options for major depressive disorder (MDD). One of the recent trends in antidepressant research has been to refine monoaminergic mechanisms by targeting monoaminergic receptors and additional transporters (e.g. with multimodal drugs and triple re-uptake inhibitors) or by adding atypical antipsychotics to SSRI or SNRI treatment. In addition, several other hypotheses of depression have been brought forward in pre-clinical and clinical research based on biological hallmarks of the disease and efficacy of pharmacological interventions. A central strategy has been to target glutamate receptors (for example, with intravenous infusions of the N-methyl-d-aspartate (NMDA) receptor antagonist ketamine). Other strategies have been based on modulation of cholinergic and γ-aminobutyric acid (GABA)ergic transmission, neuronal plasticity, stress/hypothalamic pituitary adrenal(HPA)-axis, the reward system and neuroinflammation. Here we review the pharmacological profiles of compounds that derived from these strategies and have been recently tested in clinical trials with published results. In addition, we discuss putative treatments for depression that are being investigated at the preclinical level and outline future directions for antidepressant research.

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Section: Refining and Expanding Monoaminergic Mechanisms Beyond Ssrismentioning

confidence: 99%

Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs

Dale

Bang‐Andersen

Sanchéz

2015

Biochemical Pharmacology

201

108

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“…Here is a parting note: A systematic review suggested that an antidepressant combination strategy may be a suboptimal approach to major depression in incomplete responders 20 ; augmentation with an atypical antipsychotic may be a better approach. 21 …”

Section: Discussionmentioning

confidence: 99%

Augmentation of Venlafaxine With Bupropion

Andrade

2013

J. Clin. Psychiatry

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“…Viele der existierenden Studien involvierten nur kleine Patientengruppen, wurden nicht adäquat kontrolliert oder unter Ausschluss von Patienten mit therapieresistenter Depression durchgeführt. Daher unterliegt die Empfehlung zum Einsatz der Kombinationstherapie von Antidepressiva einer fortdauernden Entwicklung [7]. Auch fehlen bisher Studien zur Langzeitbehandlung und möglichen Langzeitkomplikationen, weshalb eine Kombinationstherapie auch die höhere Gefahr potenzieller Arzneimittelinteraktionen miteinschließt [8].…”

Section: Methodsunclassified

Antidepressive Kombinationsbehandlung bei Patienten mit schwerer depressiver Episode: Verordnungspraxis am Beispiel einer klinischen Stichprobe 2012

et al. 2016

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Polypharmacy in the treatment of severe psychiatric disorders may include promising treatment options, yet may also be subject to additional side effects and interactions. In patients with severe depression, the prevalence of antidepressive (AD) combination treatment has not been thoroughly assessed yet. We assessed the prevalence of antidepressive combination treatment in a sample of hospital patients at the LVR-Clinic in Düsseldorf, Germany in 2012. 1.198 residential or semi-residential patients were diagnosed with severe depressive episode and were treated with at least one antidepressant. 25.1 % of those received a combination of at least two antidepressants. The most frequent combination approaches were tri- and tetracyclic AD with selective serotonin reuptake inhibitors (SSRI) yet various other combination approaches were observed. Combination treatment is a common strategy. Future trends could be monitored via electronic prescription software, yet prospective confirmatory trials are needed to assess the rationale of different combination treatment approaches.

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Antidepressant combination for major depression in incomplete responders—a systematic review

Cited by 23 publications

References 24 publications

Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs

Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs

Augmentation of Venlafaxine With Bupropion

Antidepressive Kombinationsbehandlung bei Patienten mit schwerer depressiver Episode: Verordnungspraxis am Beispiel einer klinischen Stichprobe 2012

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