Re: Pharmacotherapy of depression- Polypharmacy

[Guest guest]

Dear Members,

Many studies of antidepressant and antipsychotic treatment effects showed there

is an emphasis on " polypharmacy " in clinical practice, without much evidence of

benefit and an increase in adverse effects. As the number of available

medication options increases, so does the potential for polypharmacy, a practice

with possible complications including greater number of side effects and the

consequences of drug-drug interactions. It was also observed that many patients

did not receive an adequate monotherapy trial, as defined by dose and duration,

before progressing to polypharmacy. There appear to be no controlled studies

showing the superiority of combinations of drugs over monotherapy. Also there is

need to distinguish between rational and irrational polypharmacy. As response

rates with polypharmacy for the treatment of depression in clinical practice are

less and side effects are greater, I believe that the issue of polypharmacy in

psychiatric practice

should receive more scientific attention. It is important to understand the

effects of polypharmacy on efficacy of treatment of depression as well as

whether polypharmacy is instituted after appropriate initial monotherapy trials.

Regards,

Dr. Mangesh Bankar

Assistant Prof.

Pharmacology,

Nagpur

[Guest guest]

Hi,

True and I agree that irrationality is higher in Psychiatric practice and

unchecked. The polypharmacy, frequent change of medicines, incremental doses,

switch to newer medicines, sample practice all are rampant.

Vijay

>

> Dear Members,

>

> Many studies of antidepressant and antipsychotic treatment effects showed

there is an emphasis on " polypharmacy " in clinical practice, without much

evidence of benefit and an increase in adverse effects. As the number of

available medication options increases, so does the potential for polypharmacy,

a practice with possible complications including greater number of side effects

and the consequences of drug-drug interactions. It was also observed that many

patients did not receive an adequate monotherapy trial, as defined by dose and

duration, before progressing to polypharmacy. There appear to be no controlled

studies showing the superiority of combinations of drugs over monotherapy. Also

there is need to distinguish between rational and irrational polypharmacy. As

response rates with polypharmacy for the treatment of depression in clinical

practice are less and side effects are greater, I believe that the issue of

polypharmacy in psychiatric practice

> should receive more scientific attention. It is important to understand the

effects of polypharmacy on efficacy of treatment of depression as well as

whether polypharmacy is instituted after appropriate initial monotherapy trials.

>

>

>

> Regards,

>

> Dr. Mangesh Bankar

> Assistant Prof.

> Pharmacology,

> Nagpur

>