Resistant depression : potentiation strategies

• Published in: La Presse médicale (1983) 2016-03, Vol.45 (3), p.338-349
• Main Authors: Doumy, Olivier, Bennabi, Djamila, El-Hage, Wissam, Allaïli, Najib, Bation, Remy, Bellivier, Frank, Holtzmann, Jerome, Bubrovszky, Maxime, Camus, Vincent, Charpeaud, Thomas, Courvoisier, Pierre, d'Amato, Thierry, Garnier, Marion, Haesebaert, Frederic, Bougerol, Thierry, Lançon, Christophe, Moliere, Fanny, Nieto, Isabel, Richieri, Raphaëlle, Saba, Ghassen, Courtet, Philippe, Vaiva, Guillaume, Leboyer, Marion, Llorca, Pierre-Michel, Aouizerate, Bruno, Haffen, Emmanuel
• Format: Article
• Language: eng ; fre
• Subjects: Economics and Finance; Human health and pathology; Humanities and Social Sciences; Life Sciences; Psychiatrics and mental health; Psychology; Santé publique et épidémiologie
• ISSN: 0755-4982; 2213-0276
• DOI: 10.1016/j.lpm.2016.02.004

Lithium is among the most classically recommended add-on therapeutic ă strategy for the management of depressive patients showing unsuccessful ă response to standard antidepressant medications. ă The effectiveness of the add-on strategy with lithium requires achieving ă plasma levels above 0.5 mEq/L. ă Mood-stabilizing antiepileptic drugs such as carbamazepine, valproate ă derivatives or lamotrigine have not demonstrated conclusive therapeutic ă effects for the management of depressive patients showing unsuccessful ă response to standard antidepressant medications. ă Thyroid hormones are considered among the currently recommended add-on ă therapeutic strategy for the management of depressive patients showing ă unsuccessful response to standard antidepressant medications. ă The effectiveness of the add-on strategy with thyroid hormones requires ă achieving plasma concentration of TSH close to the lower limits at the ă normal range (0.4 mUI/L) or even below it. Second-generation ă antipsychotics such as aripiprazole or quetiapine have consistently ă demonstrated significant therapeutic effects for the management of ă depressive patients showing unsuccessful response to standard ă antidepressant medications. ă Second-generation antipsychotics however require the careful monitoring ă of both cardiovascular and metabolic adverse effects.