How Combination Therapy Effects Hamilton Depression

Rating Scale Scores

Ruth Vasquez, RN
College of Nursing, SUNY Upstate Medical University, Syracuse, New York

Introduction Table of Search Results Results

Depression can be a debilitating disease and has been • Augmenting treatment with psychotherapy for those with
shown to affect more women than men.1 This disease can depression resulted in improved HAM-D scores for
lead to detrimental health consequences, including death, if depressive symptoms.
left untreated.2 Middle-aged women have clinical indicators • The sooner combination therapy is implemented the more
that can make them more susceptible to depression given resulted in beneficial outcomes than later.
their sex hormones and neurotransmitters that can solicit • Patients achieved remission of depression at a
brain imbalances.1 It is important to focus on what considerably higher rate with psychotherapy than those
therapeutic processes are effectual in decreasing taking SSRI alone.
depressive moods in women. The purpose of this study is to • Risk factors that increased the likelihood of relapse
explore the question: Does combination therapy of SSRI’s included higher age, higher baseline HAM-D scores,
and psychotherapy improve HAM-D scores compared to residual depressive mood, and requiring combination
SSRI’s alone in women over the age of 40 with major therapy in order to achieve remission
depression disorder?
• Of the six studies selected, five are level two category of
evidence and one meta-analysis.
Methods Conclusion
Design Matrix of Included Studies • Patients that do not respond to a single method of
• Systematic review of the literature search that yielded 6 treatment significantly benefit from a combination therapy of
studies including a meta analysis . both psychotherapy and pharmacotherapy.
Search Protocol • Prominent themes in these studies were factors that may
• Keywords exacerbate depressive symptoms, preference of
psychotherapy, and insufficient studies in this realm.
– “depression,” “major depression,” “monotherapy,”
“combination therapy,” “SSRI,” “psychotherapy,” • Greater incidence of relapse involved patients of older age
and those that had to add combination treatment to reach
and “cognitive behavioral therapy”
remission.
• Databases
• Depending on the severity of the depression,
– Psychiatric Online, CINAHL, Pubmed, and psychotherapy alone was found to be effective in mild to
Upstate Health Sciences Library moderate depression.
• 18+ years, human, English language • Although these studies did not particularly target women, in
• Dates 2010- 2019 general psychotherapy as an option aids in reducing
Key References depressive symptoms and remain in remission.
1.  Sassarini, D. J. (2016). Depression in midlife women. Maturitas, 94, 149-154. doi: • Due to limited number of studies on this topic, future work
10.1016/j.maturitas.2016.09.004
2.  HealthyPeople 2020. (2019, March 11). Mental Health and Mental Disorders. Retrieved should investigate with more clinical trials of combination
March 11, 2019, from
https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-
therapy on women.
disorders

vasquezr@upstate.edu