Mental health problems such as depression are deeply rooted in a person’s childhood, relationships, trauma, and the way one perceives oneself. Most often than not, depression can be treated with the help of professional therapies and self-help groups. However, when it comes to major depressive disorder, you would have to take at least one antidepressant.

Generally, psychiatrists prescribe antidepressants from only one class of drugs, which is commonly called monotherapy. Be that as it may, according to researchers, providing anti-depressant from multiple classes is the best method, commonly called combination medication therapies for depression. This is considered to be the best way to treat depression according to health experts.

Initially, doctors always begin with a small dosage and then generally increase their dosage. This combination of drug therapy has been commonly used by doctors and psychiatrists in the past decade.  

However, while taking any kind of medication, it is best to give yourself some time, because you will be given a minimum amount of dosage at the beginning which will then increase gradually. Give yourself the trial period of 6 to 8 weeks and note for some changes.

If there are no changes with monotherapy, it is best to resort to the combined drug therapy.

Why is combination medication therapies for depression better?

Generally, monotherapy, that is, providing antidepressants from one type of drug, does not cause significant success in the lives of depressed people. Therefore, many types of research and psychiatrists opine in the favor of combination therapies, especially for Major Depressive Disorder (MDD).

 Combination medication therapies have proven to work best for patients suffering from chronic depression, endogenous depression, chronic depression and other severe mental problems such as anxiety and bipolar disorder.

Types of patients who require combination medication therapies for depression:

  • Depressed patients who do not respond satisfactorily to monotherapy.
  • Patients suffering from endogenous depression, which is a type of major depressive disorder (MDD), characterized by prolonged sadness and its effects on mood and physique.
  • People suffering from chronic depression
  • People having dysfunctional cognitions, which means a certain kind of deficiency in attention, verbal and non-verbal learning, short-term memory, problems in processing speed and motor functioning.
  • Unsatisfactory response to pharmacotherapy and psychotherapy.

Types of combination medications prescribed for Major Depressive Disorder (MDD):

The group of combined medications for treating MDD includes atypical antidepressants, stimulants, antipsychotics, L-triiodothyronine.

  • Atypical Antidepressants:
Combination medication therapies for depression

One of the most effective antidepressants for treating Major Depressive Disorder is bupropion, which can also be used with other medications. Bupropion is the commonly used drug in most of the combinations of therapies for depression.

It is generally combined with SSRIs, that are, selective serotonin reuptake inhibitors, which are used to ease the symptoms of moderate to severe depression. Bupropion is also used with SNRIs that are fully pronounced as serotonin-norepinephrine reuptake inhibitors (SNRIs), which help in dealing with nausea, dizziness and sweating.  

Chronic depression can also lead to some sexual side effects such as decreased libido or too much self-consciousness which makes it difficult for one to reach the climax or have any orgasm. Under such circumstances, bupropion can help you in obliterating such symptoms.

More often than not, depression can also cause loss of appetite and insomnia which affect your daily routine. Under such circumstances, mirtazapine helps in reducing the symptoms. Its side effects are generally weight gain and sedation. Be that as it may, mirtazapine is not among the combination therapies for treating major depressive disorder.  

  • Antipsychotics:

Some research is required for including antipsychotics in the field of combination medication therapy as it can even worsen the symptoms of depression. Therefore it is better to consult a doctor before taking these antipsychotics.

Be that as it may, certain atypical antipsychotics like aripiprazole if taken persistently with SSRIs (selective serotonin reuptake inhibitors) can help in reducing the symptoms of depression to a significant level.

However, there are some potential side effects of aripiprazole when taken with other medications. These potential side effects include:

  1. Fluctuations in weight, which generally lead to weight gain
  2. Muscle spasms or tremors
  3. Disruption in metabolic activities.
  • L-triiodothyronine:

Sometimes thyroid abnormalities and deficiencies can lead one to develop Major Depressive Disorder. The symptoms of hyperthyroidism include mood swings and even depression, if not medically checked.

This deficiency is again linked to the absence of a thyroid hormone called triiodothyronine, also known as T3. This thyroid hormone controls and impacts every activity that happens in our body. Be it the physiological process of growth and development to metabolism, body temperature management and appropriate heart rate.

Now, some doctors also give shots of triiodothyronine with the combination of tricyclic antidepressants (TCAS), which were probably the first of the anti-depressants to be developed. Such cyclic antidepressants are only given when people are resistant to other drugs. However, there are some negative side-effects of these antidepressants which cannot be overlooked.   

Combination medication therapies for depression

Nonetheless, research suggests that when tricyclic antidepressants are combined with triiodothyronine, people can get faster and effective results. Generally, the dose of these combination drugs required is 25 micrograms a day. However, if that dosage does not seem to generate the desired results after about a week, it can be increased to 50 micrograms.   

  • Stimulants:

Stimulant is an umbrella term in psychology that escalates the activity of the central nervous system and the body. They are very beneficial when you need a quick response and result. They work best for people suffering from chronic depression or did not show any satisfactory response to other combination therapies.  

The stimulants that are generally used with other medications include D-amphetamine (Dexedrine) and methylphenidate (Ritalin). More often than not, psychiatrists begin with low doses of antidepressants with the stimulant methylphenidate, especially when the patient is not responding well to other medications.  

It is best to consult a doctor before taking these combination medication therapies for depression as they can have severe side-effects on your mind and body. Not only that sometimes people suffering from major depression do not know whether something is wrong with them. If you feel sad, insomniac, restless, apathetic, guilty, worthless persistently for about three to four weeks accompanied by suicidal thoughts, you need to consult a professional therapist.