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Combining antidepressants: a review of evidence

  • Lena Palaniyappan, Lisa Insole and Nicol Ferrier
Summary

Sequenced (stepped) treatment approaches are widely endorsed in the management of depression. Combining antidepressants is a recognised step for those failing to respond to monotherapy. Despite the limited evidence base, this strategy is widely used by clinicians in practice. Not every combination used clinically has a sound neuropharmacological rationale and the use of such combinations may increase the side-effect burden without any additional advantage to the patient. Efficacy of various antidepressant combinations along with the data on side-effect profile and toxicity of such combined treatments are reviewed here. The different combinations are considered by each class of antidepressant available in the UK.

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Copyright
Corresponding author
Professor Nicol Ferrier, Institute of Neuroscience, Newcastle University, Leazes Wing, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK. Email: i.n.ferrier@ncl.ac.uk
Footnotes
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Declaration of Interest

N.F. has received speaker fees and educational grants from most major pharmaceutical companies. He has been on advisory boards for Astra-Zeneca, Bristol-Myers Squibb, Eli Lilly and Servier in the past 2 years but has no consultancies with or pecuniary interests in any pharmaceutical company.

Footnotes
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Combining antidepressants: a review of evidence

  • Lena Palaniyappan, Lisa Insole and Nicol Ferrier
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