Posted by SLS on May 11, 2011, at 6:02:43
In reply to Re: Dual AD Tx Same As Monotheraphy For MDD, posted by bleauberry on May 11, 2011, at 4:55:00
> 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.
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.
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.
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.
Some see things as they are and ask why.
I dream of things that never were and ask why not.