Table 30Summary of reported rates of harms for studies comparing combined therapy to other combined therapies

StudyDuration (Weeks)nComparison and Dose (mg/d)Anxiety n (%)Sedation n (%)GI Problems n (%)Sleep Problems n (%)Weight Gain n (%)Headache (n (%)Sexual Dysfunction n (%)Withdrawals Due To A/E n (%)Serious Events n (%)Suicide n (%)
Adding Non-SSRI
Altamura82,83 20085 days18SSRI + CIT 10mg in 250ml of saline2 (11.1)003 (16.7)NR1 (5.6)NR9 (50)NRNR
18SSRI + CM 25mg in 250ml of saline (intravenous)03 (18.2)2 (11.1)0NR0NR7 (39)NRNR
Trivedi113 200612286CIT + BUS 15–60mg/dNRNRNRNRNRNRNR12 (4.2)12 (4)4 (1.4)
279CIT + BUP, 200–400mg/dNRNRNRNRNRNRNR10 (3.6)11 (3.9)1 (0.36)
Augmenting Agents
Dinan125 199316SER 100–200mg/d + LI 400mg/dNRNR1 (16.1)NRNRNRNR1 (16.1)NRNR
5SER 100–200mg/d + LI 800mg/dNRNR3 (60)NRNRNRNR3 (60)NRNR
Dunner86 2007821SER 100–200mg/d + ZI 40–80mg/d5 (22.7)5 (22.7)4 (18.108 (36.4)NR4 (18.2)NR21 (100)NRNR
19SER 100–200 mg/d + ZI 80–160mg/d3 (26.3)3 (15.8)5 (26.4)6 (31.6)NR3 (15.8)NR16 (84)NRNR
Fava118 20021233FLX 20mg/d, DES 25–50mg/d10 (39.4)9 (26.5)6 (47.1)NRNR0NRNRNRNR
34FLX 20mg/d, LI 300–600mg/d011 (32.4)17 (50)NRNR9 (26.5)NRNRNRNR
Fava98 1994412FLX 20mg + DES 25–50mg/d1 (8)NRNRNRNRNRNRNRNRNR
14FLX 20mg/d + LI 300–600mg/d0NRNRNRNRNRNRNRNRNR
Adding Nonpharmacological
Trivedi113 2006
Thase110 2007
12286CIT + BUS 15–60mg/dNRNRNRNRNRNRNR12 (4.2)12 (4)4 (1.4)
239CIT + BUP, 200–400mg/dNRNRNRNRNRNRNR10 (3.6)11 (3.9)1 (0.36)
Thase110 200712117Medications CombinedNRNRNRNRNRNRNR22 (19)4^NR
1265CIT + CBTNRNRNRNRNRNRNR6 (9)4^NR

A/E = adverse event; BUP = bupropion; BUS = buspirone; CM = clomipramine; CIT = citalopram; CBT = cognitive behavioral therapy; DES = desipramine; FLX = fluoxetine; GI = gastrointestinal; LI = lithium; mg/d = milligrams per day; NR = not reported; SER = sertraline; SSRI = selective serotonin reuptake inhibitors; ZI = ziprasidone

^

At least one serious event and includes a combination of events requiring hospitalization for psychiatric event (including for suicidal ideation), death or medical event.

At least one serious event and includes a combination of events requiring hospitalization for psychiatric event (including for suicidal ideation), death or medical event.

From: Results

Cover of Treatment for Depression After Unsatisfactory Response to SSRIs
Treatment for Depression After Unsatisfactory Response to SSRIs [Internet].
Comparative Effectiveness Reviews, No. 62.
Santaguida PL, MacQueen G, Keshavarz H, et al.

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