In depression-therapy there seems to be a general positive interaction between medication
and psychotherapy. This fact is well established for tricyclics and SSRIs. With these
drugs no trial resulting in a negative interaction has been reported. Concerning other
antidepressants information on the topic is incomplete or nonexistent. St. John's
Wort (which is sold over the counter in Germany) is frequently consumed by the patients
without knowledge of the physician or the psychotherapist. No studies about a combination
of St. John's Wort and psychotherapies are available. St. John's Wort has many unexpected
interactions with other antidepressants. Neuroleptics and tranquilizers are valuable
short-term adjuncts to antidepressant therapy, but their long-term effects are questionable.
Tranquilizers may cause addiction, neuroleptics may cause side effects (movement disorders,
weight gain and sexuality). Compliance is improved by a combination of drug therapy
and psychotherapy. Whether this combination should be executed by different therapists
or the same therapist remains to be elucidated.
Antidepressants, combinations of drug therapy and psychotherapy in depressions, compliance,
St. John's Wort
