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Use of antidepressant combinations: which, when and why? Results of a Spanish survey

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de la Gándara J, Agüera L, Rojo JE, Ros S, de Pedro JM. Use of antidepressant combinations: which, when and why? Results of a Spanish survey.

Acta Psychiatr Scand 2005: 112 (Suppl. 428): 32–35. © 2005 Blackwell Munksgaard. Objective: 

The present study uses the data from a large survey conducted to examine the general practice of Spanish psychiatrists on the use of antidepressant combinations in the treatment of depressive disorders. Method: 

The sample was drawn from specialists and psychiatric residents practicing in Spain who were respondents to a questionnaire distributed during an annual national psychiatry meeting and sent by mail. Results: 

A total of 1032 questionnaires were collected; following the data-filtering, 831 were analysed. Most psychiatrists (89%) believe that many patients do not respond to the first treatment; in such cases of non-response, 58% choose a combination of antidepressants as the next treatment option. Reasons for using the combined treatments include greater efficacy (57%), overcoming resistance to the first antidepressant (27%), faster onset of action (21%) and avoidance of side effects (17%). The most sought after pharmacological profile was serotonergic-noradrenergic (96%) and the most popular combinations were selective serotonin reuptake inhibitor (SSRI) + mirtazapine, SSRI + reboxetine and SSRI + tricyclic antidepressant. Conclusion: 

Antidepressant combinations are frequently used in clinical practice. Pharmacological profiles are always considered and SSRIs + mirtazapine is the option usually chosen.
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Keywords: antidepressants; depression; drug combinations; mirtazapine; selective serotonin reuptake inhibitors; survey

Document Type: Research Article

Affiliations: 1: Hospital General Yagüe, Burgos 2: Hospital Universitario 12 de Octubre, Madrid 3: Hospital Universitàri de Bellvitge, L'Hospitalet de Llobregat 4: Hospital del Mar 5: Medical Department, Organon Spain SA, Barcelona, Spain

Publication date: 2005-11-01

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