Treatment-Resistant Depression: Your Continuum of Care
Medications for Treatment-Resistant Depression continued...
Add-on medications. Antidepressants aren't the only type of drug for treatment-resistant depression. Sometimes using an antidepressant and then adding a different type of medicine can help. This is called add-on or augmentation therapy. Some of these drugs include lithium, antianxiety drugs, anticonvulsants, and antipsychotics. Abilify, Seroquel, and Zyprexa have been FDA approved as add-on therapy in treatment-resistant depression. Symbyax is a combination drug that contains the active ingredients in Zyprexa and Prozac together in one tablet and is approved for the treatment of treatment-resistant depression. One drawback to this approach is that the more medicines you take, the greater potential for side effects.
While not truly a drug, Deplin -- a prescription medicinal food that contains folate -- is also used to enhance the effect of an antidepressant.
Where will your doctor start? It really depends on the person. Here are some of the things that your doctor will consider when deciding what drug treatment to try next.
What drugs haven't worked? If you have treatment-resistant depression, your doctor is unlikely to suggest that you go back on a medicine that didn't help. In fact, he or she might suggest shifting to a different class of medication, which might work in a completely different way in the brain.
What drugs have helped a bit, but not enough? If a particular medication has helped ease your treatment-resistant depression symptoms at least a little, your doctor might suggest that you stick with it. Then to boost the effect, you could add on a second antidepressant or a different kind of drug.
If any close relatives had depression, what medication worked for them? There might be a genetic component to how well a person responds to a medication.So something that worked for your father or sister might be more likely for work for you.
What are the side effects? Your doctor will consider how the possible side effects might affect you specifically to get a good match. For instance, some antidepressants can increase the risk of weight gain. For some, that might be unacceptable or even dangerous. But for others -- like people who have lost weight during a depression -- it could actually be a good idea.