9. Complex Combination Therapy: The Evolution Toward Rational Polypharmacy in Lithium-Resistant Bipolar Illness

  1. Hagop S. Akiskal2 and
  2. Mauricio Tohen3,4
  1. Robert M. Post,
  2. Andrew M. Speer and
  3. Gabriele S. Leverich

Published Online: 31 MAY 2006

DOI: 10.1002/0470017953.ch9

Bipolar Psychopharmacotherapy: Caring for the Patient

Bipolar Psychopharmacotherapy: Caring for the Patient

How to Cite

Post, R. M., Speer, A. M. and Leverich, G. S. (2005) Complex Combination Therapy: The Evolution Toward Rational Polypharmacy in Lithium-Resistant Bipolar Illness, in Bipolar Psychopharmacotherapy: Caring for the Patient (eds H. S. Akiskal and M. Tohen), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470017953.ch9

Editor Information

  1. 2

    International Mood Center, Department of Psychiatry at the University of San Diego and Veterans Administration Medical Center, 3350 La Jolla Village Dr. (116-A), San Diego, CA 92161, USA

  2. 3

    McLean Hospital, Harvard Medical School, Belmont, MA, USA

  3. 4

    Lilly Research Laboratories, Eli Lilly & Co, 525 S. Meridian Street, Indianapolis, IN 46225, USA

Author Information

  1. Biological Psychiatry Branch, National Institute of Mental Health, Bldg. 10, Rm. 3s239, 10 Center Drive MSC 1272, Bethesda, MD 20892–1272, USA

Publication History

  1. Published Online: 31 MAY 2006
  2. Published Print: 11 NOV 2005

ISBN Information

Print ISBN: 9780470856079

Online ISBN: 9780470017951

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Keywords:

  • complex combination therapy;
  • lithium-refractory bipolar illness;
  • antidepressant-refractory;
  • pediatric bipolar illness;
  • attention-deficit hyperactivity disorder (ADHD);
  • psychomotor retardation;
  • comorbid anxiety symptoms

Summary

This chapter contains sections titled:

  • Introduction: Prevalence and Rationales

  • The Inadequacy of Two Mood Stabilizers in Combination in Systematic Studies

  • Depression and Correlates of Poor Response to Naturalistic Polytherapy

  • Case Examples of Response to Complex Combination Therapy

  • Some Treatment Principles for Complex Combination Therapy

  • Empirical and Theoretical Rationales for Polypharmacy

  • Conclusions

  • References