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Purpose: Antidepressants possessing a wide range of pharmacological properties are available for the daily treatment of major depressive disorders (MDD). However, MDD patients with a partial response or a resistance to standard antidepressant therapy need to be treated with adjunctive psychotropic drugs such as mood stabilizers or atypical antipsychotics in order to achieve full remission. Investigation of combination pharmacotherapy in actual clinical practice could provide an insight into the features of adjunctive medications. Methods: The subjects of the study were MDD inpatients who were admitted from April 2010 to March 2013. The demographic and clinical data and prescription profiles for the psychotropic drugs at discharge were obtained from the medical charts of the patients. A statistical analysis of the data was conducted to clarify the difference between a single episode and recurrent episodes of MDD. Results: The adjunctive medication prescription rate for patients with recurrent episodes was significantly higher for antipsychotics, mood stabilizers and hypnotic drugs than that for patients with a single episode, even though no statistically significant differences were found between the two types of patients in their background characteristics. In addition, the proportion of patients who received prescriptions for both adjunctive antipsychotics and adjunctive mood stabilizers was understandably higher for recurrent MDD patients. Discussion: The present cross-sectional study demonstrated that there is a general tendency toward the prescription of multiple psychotropic drugs for the treatment of MDD inpatients, and that this tendency was more prominent in patients with recurrent episodes. Therefore, a well-designed treatment protocol that is supported by evidence from clinical trials is indispensable for the treatment of MDD in clinical practice.

clinical neuropsychopharmacology and therapeutics

A Comparison of Pharmacotherapy in Inpatients with Major Depressive Disorders Between Patients With Single Episodes and Patients With Recurrent Episodes