Polypharmacy to Optimize Depression Outcomes

Polypharmacy is used increasingly in the treatment of depression.1 Although it can be beneficial-and at times may even be unavoidable-it can also be overused, resulting in drug-drug interactions, accumulation of adverse effects, reduced treatment adherence, and unnecessary increases in the cost of health care.2 This article describes current trends in psychiatric polypharmacy in the treatment of depression along with ways to use polypharmacy to optimize treatment outcomes.

CHECK POINTS

Polypharmacy is the standard of care in many refractory medical disorders, and its use for depression is common and increasing.

Even unvalidated combinations can be used rationally by means of on-off trials in a particular patient.

Compliance should be monitored carefully before moving to polypharmacy.

If a patient has partial response to a maximum approved dosage, consider increasing dosage before adding another medication.

Polypharmacy is used increasingly in the treatment of depression.¹ Although it can be beneficial-and at times may even be unavoidable-it can also be overused, resulting in drug-drug interactions, accumulation of adverse effects, reduced treatment adherence, and unnecessary increases in the cost of health care.² This article describes current trends in psychiatric polypharmacy in the treatment of depression along with ways to use polypharmacy to optimize treatment outcomes.

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