open access

Vol 4, No 3 (2007)
Research paper
Published online: 2007-06-11
Get Citation

Polytherapy of depressive disorders. Polish psychiatrists’ preferences

Bartosz Łoza, Andrzej Czernikiewicz, Iwona Patejuk-Mazurek, Agata Roszkowska, Jonathan Britmann, Joanna Grzesiewska, Anna Mosiołek
Psychiatria 2007;4(3):97-104.

open access

Vol 4, No 3 (2007)
Prace oryginalne - nadesłane
Published online: 2007-06-11

Abstract

One of the most controversial issues of contemporary psychiatry is polytherapy, this is combined use of two drugs from one class or augmentation of one medicine with another from two different classes. Polytherapy, mostly in the augmentation mode, could be rationale in as many as 50% of depressive patients. However the evidence- -based effectiveness of combined administration of some specific medicines is not entirely proven. The popularity of polytherapy in unipolar affective disorders is based mostly on two facts: monotherapy is not as effective as needed and it is much easier to augment one drug with another than to switch medicines completely. During the seminar, which consisted of lectures, panel debates and workshop voting, 73 psychiatrists and 27 residents in psychiatry expressed their preferences regarding the polytherapy of unipolar depressive episodes. According to the participants, the most preferred medicine for augmentation is olanzapine. Olanzapine is also considered to be the most balanced drug in polytherapy of depressive episodes (it offers the best clinical profits/ /adverse effects ratio). Augmentations with mood stabilizers - lithium, valproate, lamotrigine and another atypical antipsychotic - quetiapine are also considered to be highly effective. In some cases bupropion and thyroid hormones should be administered. Stimulants, sexual hormones and herbs are the worst choice in polytherapy of depressive episodes. Paradoxically, electroconvulsive therapy is regarded as one of the most reliable, however not recommended methods. Participants would rather take advantage of augmentation than combined treatment in depressive episodes. They prefer to combine antidepressants from two main biochemical classes, i.e. serotoninergic and noradrenergic or they simply use venlafaxine instead.

Abstract

One of the most controversial issues of contemporary psychiatry is polytherapy, this is combined use of two drugs from one class or augmentation of one medicine with another from two different classes. Polytherapy, mostly in the augmentation mode, could be rationale in as many as 50% of depressive patients. However the evidence- -based effectiveness of combined administration of some specific medicines is not entirely proven. The popularity of polytherapy in unipolar affective disorders is based mostly on two facts: monotherapy is not as effective as needed and it is much easier to augment one drug with another than to switch medicines completely. During the seminar, which consisted of lectures, panel debates and workshop voting, 73 psychiatrists and 27 residents in psychiatry expressed their preferences regarding the polytherapy of unipolar depressive episodes. According to the participants, the most preferred medicine for augmentation is olanzapine. Olanzapine is also considered to be the most balanced drug in polytherapy of depressive episodes (it offers the best clinical profits/ /adverse effects ratio). Augmentations with mood stabilizers - lithium, valproate, lamotrigine and another atypical antipsychotic - quetiapine are also considered to be highly effective. In some cases bupropion and thyroid hormones should be administered. Stimulants, sexual hormones and herbs are the worst choice in polytherapy of depressive episodes. Paradoxically, electroconvulsive therapy is regarded as one of the most reliable, however not recommended methods. Participants would rather take advantage of augmentation than combined treatment in depressive episodes. They prefer to combine antidepressants from two main biochemical classes, i.e. serotoninergic and noradrenergic or they simply use venlafaxine instead.
Get Citation

Keywords

polytherapy; polypharmacy; treatment-resistant depression; treatment algorithms; treatment consensus; treatment guidelines; treatment preferences

About this article
Title

Polytherapy of depressive disorders. Polish psychiatrists’ preferences

Journal

Psychiatria (Psychiatry)

Issue

Vol 4, No 3 (2007)

Article type

Research paper

Pages

97-104

Published online

2007-06-11

Bibliographic record

Psychiatria 2007;4(3):97-104.

Keywords

polytherapy
polypharmacy
treatment-resistant depression
treatment algorithms
treatment consensus
treatment guidelines
treatment preferences

Authors

Bartosz Łoza
Andrzej Czernikiewicz
Iwona Patejuk-Mazurek
Agata Roszkowska
Jonathan Britmann
Joanna Grzesiewska
Anna Mosiołek

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest Via Medica sp. z o.o. sp. komandytowa, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl