What Is Antidepressant Augmentation?

How Antidepressant Augmentation Can Help When Depression Symptoms Linger

Antidepressat Augmentation
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Has your antidepressant helped you feel better, but you still feel like you have some lingering symptoms of depression? Antidepressant augmentation may be a good treatment strategy for you.

What Is Antidepressant Augmentation?

"Augmentation" or "combination therapy" is adding another medication to enhance the effects of the primary medication. The reasoning behind augmentation of your antidepressant is that the add-on medication will affect your brain in a different way, giving potential relief from residual symptoms not resolved by your original medication.

This could mean, for example, adding Ability or Ritalin if you're taking an SSRI like Prozac or Lexapro, to aid with residual mood symptoms.

Drugs Which Have Been Used to Augment Antidepressants

Some of the drugs which have been investigated as augments to antidepressants include:

  • Lithium
  • Thyroid Hormone
  • Buspirone
  • Pindolol
  • Dopaminergic agonists
  • Stimulants
  • Modafinil
  • Atypical antipsychotics
  • Anticonvulsants
  • Benzodiazepines
  • Glutamatergic drugs

Supplements Which Have Been Used to Augment Antidepressants

Certain over-the-counter supplements have also been investigated as potential add-on treatments, including:

Potential Risks of Antidepressant Augmentation

The risks of antidepressant augmentation are the same ones that occur anytime a person is taking multiple medications:  the risk for drug interactions and adverse reactions goes up.  Older patients are especially at risk as they tend to already be taking several different medications for various other health concerns.

  In addition, their bodies may no longer be metabolizing medications in quite the same way that a younger person would.  Rgardless of your age, you should always make sure that your doctor is aware of all medications, herbs and supplements that you are taking.

Is Augmentation Right for You?

If you feel you are not getting full relief from all of your symptoms, it is very important that you bring this up with your doctor.

Your feedback is the most valuable information your doctor has in fine-tuning your treatment plan.   Based upon whether you have had at least partial response to your medication and whether you are tolerating your current medication well, your doctor will probably either switch you to a different medication or choose a second medication to augment your current one.Generally,  if you are tolerating your current medication well and have had some response to it, you would be a good candidate for augmentation.  If you are having unbearable side effects or otherwise not doing well on your medication, then switching to a different medication would probably be advised.

Sources:

Stern, Theodore A., et. al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia: Mosby Elsevier, 2008.

Thase, Michael E.  "Augmentation Strategies in the Management of Treatment-Refractory Depression."  Medscape Multispecialty.  Medscape, LLC.  Accessed:  October 22, 2015.

Warner, Jessica and Noah S. Philip.  "Augmentation Strategies in MDD Therapy."  Psychiatric Times.  UBM Medica, LLC.  Published:  September 10, 2013.  Accessed:  October 22, 2015.

Woodruff, Kathleen.  "Preventing Polypharmacy in Older Adults."  American Nurse Today.  5.10 (2010).

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