title: [Switching and combining strategies of antidepressant medications].
abstract: Switching antidepressant medication may be helpful in depressed patients having no benefit from the initial antidepressant treatment. Before considering switching strategy, the initial antidepressant treatment should produce no therapeutic effect after at least 4 weeks of administration at adequate dosage. Choosing an antidepressant of pharmacologically distinct profile fails to consistently demonstrate a significant superiority in terms of effectiveness over the switching to another antidepressant within the same pharmacological class. Augmenting SSRI/SNRIs with mirtazapine/mianserin has become the most recommended strategy of antidepressant combinations. Augmenting SSRI with tricyclic drugs is now a less recommended strategy of antidepressant combinations given the increased risk for the occurrence of pharmacokinetic drug-drug interactions and adverse effects.
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France. Electronic address: tcharpeaud@chu-clermontferrand.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Charpeaud
authors.affiliation: CHRU Lapeyronie, centre expert dépression résistante fondamental, département des urgences et post-urgences psychiatrique, 34295 Montpellier cedex 5, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Moliere
authors.affiliation: CHRU de Lille, hôpital Fontan 1, centre expert dépression résistante fondamental, service de psychiatrie adulte, 59037 Lille cedex, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Bubrovszky
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Haesebaert
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Najib
authors.initials: N
authors.lastname: Allaïli
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Bation
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Isabel
authors.initials: I
authors.lastname: Nieto
authors.affiliation: CHU La-Conception, pôle psychiatrie centre, centre expert dépression résistante fondamental, 13005 Marseille, France.
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Richieri
authors.affiliation: Hôpital Chenevier, Henri-Mondor, pôle de psychiatrie des hôpitaux universitaires, centre expert dépression résistante fondamental, 94000 Créteil, France.
authors.forename: Ghassen
authors.initials: G
authors.lastname: Saba
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: CHU de Besançon, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, 25030 Besançon cedex, France.
authors.forename: Djamila
authors.initials: D
authors.lastname: Bennabi
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Holtzmann
authors.affiliation: CHU de Tours, clinique psychiatrique universitaire, centre expert dépression résistante fondamental, 37044 Tours cedex 9, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Camus
authors.affiliation: CHRU Lapeyronie, centre expert dépression résistante fondamental, département des urgences et post-urgences psychiatrique, 34295 Montpellier cedex 5, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Courvoisier
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: d'Amato
authors.affiliation: CH Charles-Perrens, pôle de psychiatrie générale et universitaire, centre expert dépression résistante fondamental, 33076 Bordeaux cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Doumy
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Garnier
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bougerol
authors.affiliation: CHU La-Conception, pôle psychiatrie centre, centre expert dépression résistante fondamental, 13005 Marseille, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lançon
authors.affiliation: CHU de Besançon, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, 25030 Besançon cedex, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Haffen
authors.affiliation: Hôpital Chenevier, Henri-Mondor, pôle de psychiatrie des hôpitaux universitaires, centre expert dépression résistante fondamental, 94000 Créteil, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: CHRU de Lille, hôpital Fontan 1, centre expert dépression résistante fondamental, service de psychiatrie adulte, 59037 Lille cedex, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Vaiva
authors.affiliation: CHU de Tours, clinique psychiatrique universitaire, centre expert dépression résistante fondamental, 37044 Tours cedex 9, France.
authors.forename: Wissam
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: CH Charles-Perrens, pôle de psychiatrie générale et universitaire, centre expert dépression résistante fondamental, 33076 Bordeaux cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Aouizerate
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004351:Drug Resistance; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000928:Antidepressive Agents