Psychiatria pre prax 1/2003

POSSIBILITIES OF COMBINATION OF PSYCHOTHERAPEUTICS IN CLINICAL PRACTICE

The authors describe reasons, history and occurrence of both antidepressants and antipsychotics combinations in depressive and schizophrenic disorders. Own results with their use in Brno region are compared with the literature. Further concrete possibilities are presented and their advantages and disadvantages are summarised. The most promising seem to be combinations of drugs with different (respective complementary) pharmacological profiles. In spite of frequent use of combinations the studies concerning the efficacy of this strategy are scare. Using combinations, the theoretical reasons and possible risks should be considered. The polypharmacy may be explained by the availability of new more specific and safer psychopharmacs, reality of clinical praxis and last but not least by economic reasons. In the near future more controlled studies with greater number of treated should be performed, aimed at the evaluation of combination efficacy.

Keywords: depressive disorder, schizophrenic disorder, pharmacoresistance, combination of antidepressants, combination of antipsychotics.