Combination therapy and the depressed woman

Abstract While the question of the relative efficacy of combination pharmacotherapy and psychotherapy vs. either therapy alone has received some research attention within the last 25 years, the authors attempt to narrow the focus of this question by discussing the possibility that combination therapy may be of special value for women with major depression. Theoretical models explaining why combination therapy, in general, might be expected to be more effective are described. The authors then discuss reasons why combination therapy might be a particularly efficacious treatment for depressed women, including greater psychosocial stress prior to and resulting from depression and increased cognitive distortion, both of which are more associated with depression in females. Despite a reasonable theoretical rationale for the superiority of combination in comparison to either monotherapy, examination of the available literature on acute, continuation, and maintenance treatment studies generally failed to find benefits for the use of combination therapy. Similarly, examination of the literature for gender differences among patients treated with combination therapy failed to find a specific benefit of this treatment for women. Possible reasons for these findings and suggestions for future studies are discussed. Depression 3:91–98 (1995). © 1995 Wiley‐Liss, Inc.