Major Depression and Medication Management

A high percentage of patients suffering from major depression often need to be treated with more than one medication or medication augmentation, especially the treatment refractory patients. A new study of patients with treatment resistant depression was conducted with the medications Symbyax and Prosac. The goal of the study was to observe major depression and medication management responses in treating major depression, patients with treatment resistant depression being treated from the onset with both Symbyax and Prosac experienced a very early improvement during acute episodes and used in times of relapse. Dealing with major depression is of great interest since the recurrences of depressive episodes ranges from 10% up to 60%. I believe these relapses that occur after treating major depression is often due in part to the medication treatment not continuing for at least 12 months after the symptoms have subsided which often is due to the patient’s belief that they have been “cured” and their stopping treatment, and resistance to taking multiple medications.

The study showed the importance of treating major depression with both medications from the start. The group in the study that was given a combination of the medications from the onset began to see an improvement in their conditions within the first 2 weeks compared to the other groups (to the degree of 25% in some cases) that saw either delayed responses ranging from 3 to 8 weeks before the symptoms were reduced still other groups given only one of the medications saw no efficacy at all during the 8 week treatment. The overall treatment using the adjunct therapy of the two medications also showed better long term results in the patient groups as well.

The conclusion is that in using a combination of the two medications from the onset will be more likely to yield a faster acting affect on the depressive symptoms and also a better prognosis overall. Unfortunately many patients are resistant to taking multiple drugs, however the benefits of the augmentation often out weighs any concerns they may have. Additionally this will give the patient more immediate relief from the symptoms of the depressive disorder, it will provide quicker information to the doctor with regards to having chosen the right course of treatment; and it will give the patient more confidence in medication management.

One of the challenges of treating patients with an adjunct approach to treating major depression with both medications are the possible side effects, knowing the necessity of the augmentation beforehand, the cost to the patient and side effects will be more acceptable. I believe that a few factors in determining when to use this approach will be revealed during the patient evaluation. If a patient has revealed that he or she is experiencing a relapse from a former treatment, or has been treated for depression before and the treatment has not produced any noticeable relief from the symptoms; these patients might be good candidates to begin with an augmentation treatment approach from the start. Another good candidate would be severely depressed patients that come to you for the first time and are extremely debilitated, they might benefit from this rapid onset response of both medications, after some degree of stabilizations has been achieved, backing off to one or the other medications can be discussed with the patient; however in any case, every patient should be informed at the unset of depression treatment of the necessity to remain on the medications for the longer period of time to avoid relapse; in which case the effects of the relapse would be much worse than an extended medication treatment plan. Treating major depression can be very effective in a relatively short time frame if the right approach is taken from the start. In these cases the patient must assess the pros and cons and weigh the consequences of medication augmentation against their symptoms and quality of life. Read more about  major depression at About Major Depression and Medication Management.

this article is for informative purposes and not to be used to treat any mental health issue