Drugs combinations for treatment-resistant unipolar depression

Despite attempts to optimize antidepressant therapy, a substantial number of patients still fail to respond to the antidepressant prescribed. Up to 30% percent of patients with major depression fail to respond to conventional treatment. Another problem with the antidepressant treatment is loss of efficacy or emergence of depressive symptoms despite ongoing antidepressant treatment. That's why alternative approaches are still required. Augmentation or drug combination treatment is one of these alternative strategies. In this paper, beside major augmentation strategies such as lithium and thyroid hormone augmentation, novel strategies such as pindolol, atypical antipsychotics and psychostimulant augmentation of antidepressant treatment is reviewed in view of the literature.