Introduction | Diagnostic Indications and Contraindications | Evidence for Acute-Phase Efficacy | Evidence for Continuation- and Maintenance-Phase Efficacy | Side Effects and Serious Adverse Events | Clinical Applications of Combined Treatment | Conclusion | References
Both drugs and psychotherapy have a role to play in the treatment of the mood disorders. Pharmacotherapy has been shown to be effective in literally hundreds of placebo-controlled trials and represents the current standard of treatment for both depression and mania (American Psychiatric Association 2000). Psychotherapy is widely practiced but has been less intensively studied. It has fared well in direct comparisons with pharmacotherapy, particularly the newer approaches tailored specifically for depressed populations (Hollon et al. 2002). Given the apparent efficacy of both monotherapies, it is not surprising that the two are sometimes combined. Both biological and psychosocial factors have been implicated in the etiology of the mood disorders, and it is often assumed that both medications and psychotherapy work through different mechanisms for different types of patients. Concerns among advocates that combined treatment might undercut the efficacy of their preferred modality have proved to be largely unfounded, and many patients are now treated with a combination of medication and psychotherapy (Thase and Jindal 2004).