Antiepileptic Drug Augmentation for Treatment-Resistant Depression

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Letter to the Editor

Sir: The recent case report by Ketter, Callahan, and Post1 illustrating a positive therapeutic drug/drug interaction for treatment-resistant anxious depression is an example of outstanding psychopharmacologic strategizing. The authors explain their successful outcome, achieved when nefazodone was added to alprazolam, with a pharmacokinetic model, hypothesizing that nefazodone extended the duration of action of alprazolam through inhibiting its degradation by the cytochrome P450 3A3/4 system, thereby eliminating “interdose dysphoria.”

J Clin Psychiatry 1997;58(8):361-362