Talk:Combination therapy

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Some examples that are typically treated with combination therapy and which illustrate its various motivations: HIV is treated with multiple antiretrovirals in order to avoid antiviral resistance which was a much bigger problem pre-HAART.

Most psychiatric illnesses are treated with some combination of psychiatric medication and psychotherapy, however two disorders illustrate the intricacies best: bipolar disorder is often treated with a mood stabiliser plus an antipsychotic as mood stabilisers do little to treat an ongoing major depressive episode. However, in some cases an antidepressant is desired for its more potent antidepressant effect, but antidepressant monotherapy is not appropriate even for people with bipolar II as it can trigger a manic episode, mixed state, affective switching, or rapid cycling. As a result, bipolar disorder tends to be managed with various medications for a single patient, with the ones taken on a given day being dependent on if the individual is experiencing a manic or depressive episode or a mixed or euthymic state. While medication is the principal treatment for bipolar disorder, perhaps due to the complex medication regimen psychotherapy is often also used, particularly with the goal of preventing episodes from occurring to begin with.

The other disorder which illustrates the goals of combination therapy is borderline personality disorder - quite frequently comorbid with bipolar disorder, as well as each disorder being misdiagnosed as the other - for which the treatment is psychotherapy only in most cases, with medication being used when indicated by a comorbidity or in patients whose impulsive anger is likely to be destructive, and with the aim being to cease medication when impulse control and emotion regulation have been improved with psychotherapy. Furthermore, medication is likely to be necessary in the first year of psychotherapy, because in the treatment of this disorder, it is common for considerable regression to occur in that first year. This makes the lack of specific pharmacological treatment for borderline personality disorder particularly frutrating, although medications used for bipolar disorder, particularly aripiprazole, are often used to rein in the extremes of mood which tend to be what triggers the acting on potentially destructive impulses. Anditres (talk) 06:44, 15 March 2023 (UTC)[reply]