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Combining antidepressants: A review of evidence

Lookup NU author(s): Dr Lena Palaniyappan, Dr Lisa Insole, Emeritus Professor Nicol Ferrier


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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.

Publication metadata

Author(s): Palaniyappan L, Insole L, Ferrier I

Publication type: Review

Publication status: Published

Journal: Advances in Psychiatric Treatment

Year: 2009

Volume: 15

Issue: 2

Pages: 90-99

ISSN (print): 1355-5146

ISSN (electronic): 1472-1481


DOI: 10.1192/apt.bp.107.004820