Editing Antidepressant (section)

==Adjuncts==
Adjunct medications are an umbrella category of substances that increase the potency or "enhance" antidepressants.<ref>{{cite web|url=http://www.merckmanuals.com/professional/psychiatric_disorders/mood_disorders/depressive_disorders.html?qt=depression&alt=sh#v1028590|website=Merck Manual|title=Depressive Disorders|access-date=30 November 2012|archive-url=https://web.archive.org/web/20131205163219/http://www.merckmanuals.com/professional/psychiatric_disorders/mood_disorders/depressive_disorders.html?qt=depression&alt=sh|archive-date=5 December 2013}}</ref> They work by affecting variables very close to the antidepressant, sometimes affecting a completely different [[mechanism of action]]. This may be attempted when depression treatments have not been successful in the past.

Common types of adjunct medication techniques generally fall into the following categories:

* Two or more antidepressants taken together, from either the same or different classes (affecting the same area of the brain, often at a much higher level).
* An [[antipsychotic]] combined with an antidepressant, particularly [[atypical antipsychotic]]s such as [[aripiprazole]] (Abilify), [[quetiapine]] (Seroquel), [[olanzapine]] (Zyprexa), and [[risperidone]] (Risperdal).<ref name="Maudsley">{{cite book|vauthors=Taylor D, Carol P, Shitij K|title=The Maudsley prescribing guidelines in psychiatry|year=2012|publisher=Wiley-Blackwell|location=West Sussex|isbn=978-0-470-97969-3}}</ref><!--first added https://en.wikipedia.org/w/index.php?title=Antidepressant&diff=prev&oldid=576824896-->
It is unknown if undergoing [[psychological therapy]] at the same time as taking anti-depressants enhances the anti-depressive effect of the medication.<ref>{{cite journal|vauthors=Cox GR, Callahan P, Churchill R, Hunot V, Merry SN, Parker AG, Hetrick SE|title=Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents|journal=The Cochrane Database of Systematic Reviews|volume=2014|issue=11|pages=CD008324|date=November 2014|pmid=25433518|pmc=8556660|doi=10.1002/14651858.CD008324.pub3|url=http://vuir.vu.edu.au/33744/1/Cox%20et%20al%202012%20Psychological%20therapies%20versus%20antidepressant%20medication%20%28Review%29.pdf|url-status=live|hdl-access=free|hdl=11343/59254|archive-url=https://ghostarchive.org/archive/20221009/http://vuir.vu.edu.au/33744/1/Cox%20et%20al%202012%20Psychological%20therapies%20versus%20antidepressant%20medication%20%28Review%29.pdf|archive-date=9 October 2022}}</ref>

===Less common adjuncts===
[[Lithium (medication)|Lithium]] has been used to augment antidepressant therapy in those who have failed to respond to antidepressants alone.<ref name="pmid10505584">{{cite journal|vauthors=Bauer M, Dopfmer S|s2cid=31979046|year=1999|title=Lithium augmentation in treatment-resistant depression: Meta-analysis of placebo-controlled studies|journal=Journal of Clinical Psychopharmacology|volume=19|issue=5|pages=427–34|pmid=10505584|doi=10.1097/00004714-199910000-00006}}</ref> Furthermore, Lithium dramatically decreases the suicide risk in recurrent depression.<ref name="pmid17388706">{{cite journal|vauthors=Guzzetta F, Tondo L, Centorrino F, Baldessarini RJ|s2cid=10343453|title=Lithium treatment reduces suicide risk in recurrent major depressive disorder|journal=J Clin Psychiatry|volume=68|issue=3|pages=380–83|date=March 2007|pmid=17388706|doi=10.4088/JCP.v68n0304}}</ref> There is some evidence for the addition of a thyroid hormone, [[triiodothyronine]], in patients with normal thyroid function.<ref name="pmid16946176">{{cite journal|vauthors=Nierenberg AA, Fava M, Trivedi MH, Wisniewski SR, Thase ME, McGrath PJ, Alpert JE, Warden D, Luther JF, Niederehe G, Lebowitz B, Shores-Wilson K, Rush AJ|year=2006|title=A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: A STAR*D report|journal=American Journal of Psychiatry|volume=163|issue=9|pages=1519–30|pmid=16946176|doi=10.1176/appi.ajp.163.9.1519}}</ref>

Psychopharmacologists have also tried adding a [[psychostimulant|stimulant]], in particular, [[D-amphetamine]].<ref>{{cite book|vauthors=Stahl SM|title=The Prescriber's Guide (Stahl's Essential Psychopharmacology)|year=2011|publisher=Cambridge University Press|page=39}}</ref> However, the use of stimulants in cases of treatment-resistant depression is relatively controversial.<ref name="pmid1411740">{{cite journal|vauthors=Kraus MF, Burch EA|title=Methylphenidate hydrochloride as an antidepressant: controversy, case studies, and review|journal=Southern Medical Journal|volume=85|issue=10|pages=985–991|date=October 1992|pmid=1411740|doi=10.1097/00007611-199210000-00012}}</ref><ref name="pmid17338594">{{cite journal|vauthors=Orr K, Taylor D|title=Psychostimulants in the treatment of depression : a review of the evidence|journal=CNS Drugs|volume=21|issue=3|pages=239–257|date=2007|pmid=17338594|doi=10.2165/00023210-200721030-00004|s2cid=35761979}}</ref> A review article published in 2007 found psychostimulants may be effective in treatment-resistant depression with concomitant antidepressant therapy, but a more certain conclusion could not be drawn due to substantial deficiencies in the studies available for consideration, and the somewhat contradictory nature of their results.<!--

commented out 19 November 2013

However, the authors claim psychostimulants are likely to have a higher level of clinical effectiveness under circumstances in which the patient will probably die soon, so rapid relief is of great importance. In this situation, the patient is likely to die before dependence on, or tolerance of, the medication interferes with their care.

note 15 September 2015

This content should likely be incorporated into the article in some form, likely by mentioning the usage for fatigue in cancer (among others), but it's not happening right now, so please leave this commented out content in place as an important reminder for future editors.

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