The simultaneous use of 2 antidepressants ...

The simultaneous use of 2 antidepressants with different chemical structure is justified as an admission of overcoming resistance to therapy, but only after at least 2 full courses of monotherapy with different antidepressants. It should be noted that resistant depression is an indication for inpatient treatment, preferably in specialized institutions. This is due to difficulties in selecting therapy, the need for a higher than acceptable in the outpatient setting, doses of drugs, a higher risk of suicide. The real, clinically adequate duration of therapy (usually estimated by several months) is not determined by the absence of rapid onset of therapeutic outcome (it would normally be expected in 3-6 weeks) and the known laws of return of depression, the removal of the prerequisites of relapse or commit a rudimentary symptoms. Several months' use of antidepressants (already beyond the reach of the apparent improvement) also belongs to the modern principles of treatment of depression: the past, as noted above, the breaking of depression, lack of primary and secondary symptoms of depression within 2 weeks is usually considered a sufficient reason for the rapid decrease in successive doses of an antidepressant to minimum or even to stop taking it. Tolerability and safety of antidepressant drugs are particularly important in modern therapy. Portability involves no significant side effects, as is obvious to the patient (eg, dry mouth, headaches, visual disturbances, which can serve as breeding grounds for subjective intolerance), and are not always obvious changes in heart rate, blood pressure, effects of behavioral toxicity such as breach of fine motor coordination, reduced wakefulness, cognitive disorders (attention span, memory, speed of execution of logical operations, spatial orientation). Cognitive impairment is particularly important for the working person dealing with the constant intellectual component in the performance of professional functions. Modern intellectualization of labor, use of technology, particularly computer, intermediaries activities, and frequent execution of operator actions that require constant change and re-focus, communication all require a modern treatment of benign and supportive (at least not the oppressor), cognitive function properties. Recently, more attention when antidepressant therapy is justified on safety of sexual function, the lack of antidepressant side effects such as weakening of erection, delay ejaculation, repression of orgasm. Please keep in mind that sexual function (libido, especially) are in themselves suffering with depression and logical manner restored when adequate antidepressant therapy.