What's Best for Depression: Single Drug Or a Combination?

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In many fields of medicine physicians often find that a combination of medications produces better outcomes than does a single medication. Researchers at the University of Texas Southwestern Medical Center in Dallas wanted to see if that holds true for depression treatment as well on the factors of patient retention in treatment, side-effect burden, and quality of life. They enrolled in their study 660 outpatients with major nonpsychotic depression from primary care and psychiatry practices. Patients were assigned to one of three groups: escitalopram plus placebo (monotherapy), bupropion plus escitalopram, or venlafaxine plus mirtazapine.

The researchers found that remission and response rates were not significantly different at either 12 weeks or seven months after the start of the study, and the same held true for quality-of-life and social-adjustment measures. Both of the combination treatments led to more side effects than did monotherapy. The researchers concluded that combinations of SSRI antidepressants offered no advantages as first-line treatments.

Read more about this study in Psychiatric News, at http://pn.psychiatryonline.org/content/46/13/23.2.full.