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Combination Strategies in Treatment-Resistant Depression

  • Francisco López-Muñoz
  • Cecilio Álamo
  • Pilar García-García
Chapter

Abstract

Treatment-resistant depression (TRD) is a serious public health problem: high prevalence (40–50 % of outpatient depression patients fail to respond satisfactorily to treatment with antidepressants in monotherapy, with the correct dose, regime and duration); social significance (high medical cost); individual suffering it causes (poor prognosis, chronicity, increased risk of suicide). The combination strategy is an option being used more and more frequently at the clinical level, and tends to be effective in 50–60 % of cases, though this varies according to the drug employed. This review analyze the state of the evidence on this therapeutic strategy, focusing on the family of antidepressants known as selective noradrenaline reuptake inhibitors (NARIs), particularly reboxetine, one of the antidepressants most widely used in combination therapy for TRD in recent years. The results obtained in combination strategies with reboxetine–especially in conjunction with SSRIs–suggest that it is a potentially useful tool.

Keywords

Major Depressive Disorder Remission Rate Combination Strategy Lithium Salt Depression Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer India 2016

Authors and Affiliations

  • Francisco López-Muñoz
    • 1
    • 2
    • 3
  • Cecilio Álamo
    • 4
  • Pilar García-García
    • 4
  1. 1.Faculty of Health SciencesCamilo José Cela UniversityMadridSpain
  2. 2.Neuropsychopharmacology UnitHospital 12 de Octubre Research Institute (i+12)MadridSpain
  3. 3.Portucalense Institute of Neuropsychology and Cognitive and Behavioural NeurosciencesPortucalense UniversityPortoPortugal
  4. 4.Department of Biomedical Sciences (Pharmacology Area), Faculty of Medicine and Health SciencesUniversity of AlcaláMadridSpain

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