[Good and bad therapeutic combinations in the treatment of resistant XXXX ].

@entity1 @entity162 @entity308 @entity137 @entity1949 @entity2931 @entity2515 @entity2340 @entity889 @entity1091 @entity2049
The definition of resistant @entity308 is imprecise and variable according to the different authors. In most cases, the definition concerns @entity308 @entity1 who have received well managed treatment with optimal doses of a thymoanaleptic over a sufficiently long period of time. The distinction of @entity162 ( @entity162 ) with a rapid cycle also raises the problem of resistance to the prophylactic effect of mood regulators in @entity162 . The inefficacy of treatment in at least 20% of cases of @entity308 has led a number of authors to propose original drug combinations with the aim of potentiating the action of previous treatments. Most of the studies published report isolated cases in which the therapeutic approach is often empirical and rarely explained. The most frequently reported combination is that of 2 drugs, generally including one antidepressant. Such combinations can induce pharmacodynamic or pharmacokinetic interactions resulting in either a potentiation or a reduction of the effects of one of the 2 drugs or to the induction of @entity137 . These last two possibilities illustrate what the authors describe as "bad combinations". Various drug combinations are reviewed and critically analysed. The most interesting and best documented combinations involve the addition of @entity1091 , MAOI and thyroid hormones to tricyclic treatment in non-responding @entity1 . Other combinations with tricyclics have been reported less frequently: ECT, neuroleptics, @entity2515 , @entity2049 , 5 HTP, @entity2340 , @entity889 , @entity2931 , @entity1949 .(ABSTRACT TRUNCATED AT 250 WORDS)
