The pharmacologic meaning of successful antipsychotic-antidepressant combinations

Abstract

We have attempted in this article to underline the value of a two-way inter-change between pharmacologically knowledgeable clinicians and clinically astute pharmacologists. From our vantage point as clinicians with a working knowledge of basic pharmacologic research, we thought that certain commonly accepted clinical observations would be of interest to the pharmacologist. The clinical observation that antipsychotic and antidepressant drugs may exert their respective therapeutic effects independently when used in combination in patients displaying mixed symptomatology seems to have important pharmacologic implications. Considered in light of current pharmacologic concepts, this clinical observation argues that the mechanisms of action of antipsychotic and antidepressant drugs involve different biogenic amines at different anatomic sites. This argument reinforces current data from the laboratory and the clinic suggesting that dopamine systems are crucial to the etiology and therapy of schizophrenic psychosis and that norepinephrine systems are crucial to the etiology and therapy of depression.