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Combining Meds for Depression: The State of The Art

In surveys, it’s clear that most psychiatrists practice as unimaginatively as I typically do, meaning that their drug of first choice for most depressed patients is an SSRI (Petersen T, et al., Prog Neuropsychopharmacol Biol Psychiatry 2002; 26:177-187). If SSRIs don’t work, there are various options. Optimization, or raising the dose, is one option, and is covered in another article in this issue. Many of us will eventually move on to a combination/augmentation strategy. But it's becoming increasingly difficult to know which combinations to use. The evidence becomes murkier with each new study. Here’s a brief, selective run-down of the state of the art.

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