ABSTRACT
Given the information provided in earlier chapters regarding acute outcomes and the potential prophylactic effects of long-term maintenance pharmacotherapy for major depressive disorder (MDD), it seems worthwhile to continue the development of safer and more tolerable antidepressant agents. Short of this and due to a narrow potential pipeline, we must often rely on polypharmacy techniques to achieve remission as noted in the last chapter. What about the use of polypharmacy to mitigate acute and chronic adverse events? The continuation of pharmacotherapy in patients who have experienced sufficient symptom improvement during the acute phase of treatment has been repeatedly shown to minimize the risk of recurrence of depression (1) as noted, and it appears that antidepressant remitters who continue to receive pharmacotherapy on a long-term basis and remain in remission experience an improvement in psychosocial functioning, while antidepressant remitters who were switched to placebo and sustained remission experience a worsening of psychosocial functioning (2). As a result, it is becoming
increasingly apparent to clinicians and patients alike that long-term compliance with treatment is necessary to successfully recover from depression and restore the premorbid level of functioning or ‘‘wellness.’’ Therefore, to increase the likelihood of adherence to treatment in addition to minimizing the degree of discomfort and impairment, it is important for physicians to identify and address side effects during the course of pharmacotherapy. In the following chapter, we will review the evidence reporting on the use of pharmacotherapeutic strategies for the treatment of antidepressant-associated side effects.
