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Combination Therapies and Switching of Agents in Depression and Bipolar Disorders

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NeuroPsychopharmacotherapy

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Abstract

Major depressive disorder (MDD) and bipolar disorder (BD) are psychiatric disorders with a high morbidity and mortality. Both disease entities share in common that there are statistically relatively low response and remission rates after a first monotherapeutic medication trial (regarding the treatment of depressive episode in MDD and BD as well as the treatment of manic episodes in BD). This routinely presents the responsible clinician with the challenge to decide how to proceed in the treatment in case of non-response or non-remittance.

This article aims to summarize the current evidence-based treatment options concerning possible combination therapies or switching of agents in MDD and BD. In addition to this, regarding the treatment of depressive and manic episodes in BD, we also present the existing evidence for combination therapies as initial treatment regimen. Furthermore, the possible mechanisms of action that might underlie the effect of the mentioned treatment strategies are discussed.

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Authors and Affiliations

  1. Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Lower Saxony, Germany

    Thorsten Folsche, Hannah Benedictine Maier & Helge Frieling

  2. Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Bavaria, Germany

    Thomas Hillemacher

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  1. Thorsten Folsche
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  2. Hannah Benedictine Maier
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  3. Thomas Hillemacher
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  4. Helge Frieling
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Correspondence to Thomas Hillemacher or Helge Frieling .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

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  1. Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary

    István Bitter

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Folsche, T., Maier, H.B., Hillemacher, T., Frieling, H. (2022). Combination Therapies and Switching of Agents in Depression and Bipolar Disorders. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_437

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