Resistant depression : Switching and combining strategies of ă antidepressant medications

International audienceSwitching antidepressant medication may be helpful in depressed patients ă having no benefit from the initial antidepressant treatment. ă Before considering switching strategy, the initial antidepressant ă treatment should produce no therapeutic effect after at least 4 weeks of ă administration at adequate dosage. ă Choosing an antidepressant of pharmacologically distinct profile fails ă to consistently demonstrate a significant superiority in terms of ă effectiveness over the switching to another antidepressant within the ă same pharmacological class. ă Augmenting SSRI/SNRIs with mirtazapine/mianserin has become the most ă recommended strategy of antidepressant combinations. ă Augmenting SSRI with tricyclic drugs is now a less recommended strategy ă of antidepressant combinations given the increased risk for the ă occurrence of pharmacokinetic drug-drug interactions and adverse ă effects