Posted by bleauberry on May 14, 2011, at 5:20:12
In reply to Re: Dual AD Tx Same As Monotheraphy For MDD » bleauberry, posted by SLS on May 11, 2011, at 6:02:43
I whole heartedly agree with everything you pointed out Scott, and thank you for illustrating. I do believe there were better, less trendy, less politcally correct, meds that were ignored....parnate, clomipramine, milnacipran, nardil, prozac+zyprexa, prozac+ritalin, zoloft+nortriptyline. Now, had they based their conclusions by incorporating those in the study, I would give the study more credence than I currently do.
I am almost always suspect of studies anyway.
> > This study has a number of flaws and possible bias. The one thing that stood out in my mind was how they made a blanket statement concerning dual ADs, when the most appropriate potent dual AD combos were not even used. Not a single TCA in there. I think they put more credence in Wellbutrin than it deserves....it did not pass the test as an antidepressant in other countries. Why use such a lame AD? Remeron isn't exactly a powerhorse either.
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> The point of combining antidepressants is to bring about a therapeutic response which is absent when using these drugs separately. Neither drug needs to be globally potent as an antidepressive agent. As an example, buspirone makes a terrible antidepressant. Yet, it can turn someone from a non-responder to a responder. Two drugs need only have complementary mechanisms of action that produce a synergy.
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> Sorry, but Wellbutrin makes an excellent choice as an augmenting agent to SRIs, especially with an SNRI. "Welloft" is a term used by doctors to indicate the synergy they observed between Wellbutrin and Zoloft.
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> It is my guess that ritanserin, a selective 5-HT2a/b/c antagonist would make a good adjunct to standard antidepressants, despite having very little therapeutic properties on its own. I haven't searched online for any investigations of this idea.
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> - Scott
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poster:bleauberry
thread:985044
URL: http://www.dr-bob.org/babble/20110502/msgs/985284.html