Combination antidepressant therapy in primary care.
Increasing clinical experience with the selective serotonin reuptake inhibitors and tricyclic antidepressants make combination antidepressant therapy at times a reasonable alternative to single-agent therapy in primary care patients with depression. This article describes three cases that illustrate possible rationales for combination antidepressant therapy: reduced side effects, synergistic treatment effects, reduced treatment response time, prescriber familiarity, and clinical experience. The combination of selective serotonin reuptake inhibitors and tricyclic antidepressants may be useful in treating patients who experience intolerable side effects or who are resistant to therapy with a single antidepressant. Further research should be done to define the role of combination antidepressant therapy in the treatment of primary care patients with depression.
King
D E
DE
Department of Family Medicine, East Carolina University School of Medicine, Greenville, NC.
Finestone
D H
DH
Peden
J G
JG
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D011320:Primary Health Care; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors