Augmentation (pharmacology)

Augmentation, in the context of the pharmacological management of psychiatry, refers to the combination of two or more drugs to achieve better treatment results. Examples include:

Prescribing an atypical antipsychotic when someone is already taking a selective serotonin reuptake inhibitor for the treatment of depression.^[1]
Prescribing estrogen for someone already being treated with antipsychotics for the management of schizophrenia.^[2]
Giving an adenosine A2A receptor antagonist on top of existing treatment for Parkinson's disease.^[3]

In pharmacology, the term is occasionally used to describe treatments that increase (augment) the concentration of some substance in the body. This might be done when someone is deficient in a hormone, enzyme, or other endogenous substance. For example:

Use of DDCIs in addition to L-DOPA, to reduce conversion of L-DOPA outside the brain.
To give α1 antitrypsin to someone with alpha 1-antitrypsin deficiency.^[4]

^ Wright, BM; Eiland EH, 3rd; Lorenz, R (March 2013). "Augmentation with atypical antipsychotics for depression: a review of evidence-based support from the medical literature". Pharmacotherapy. 33 (3): 344–59. doi:10.1002/phar.1204. PMID 23456734. S2CID 2421659.{{cite journal}}: CS1 maint: numeric names: authors list (link)
^ Begemann, MJ; Dekker, CF; van Lunenburg, M; Sommer, IE (November 2012). "Estrogen augmentation in schizophrenia: a quantitative review of current evidence". Schizophrenia Research. 141 (2–3): 179–84. doi:10.1016/j.schres.2012.08.016. PMID 22998932. S2CID 40584474.
^ Zhu, C; Wang, G; Li, J; Chen, L; Wang, C; Wang, Y; Lin, P; Ran, H (November 2014). "Adenosine A2A receptor antagonist istradefylline 20 versus 40 mg/day as augmentation for Parkinson's disease: a meta-analysis". Neurological Research. 36 (11): 1028–34. doi:10.1179/1743132814y.0000000375. PMID 24725292. S2CID 206852879.
^ Campos, MA; Lascano, J (October 2014). "α1 Antitrypsin deficiency: current best practice in testing and augmentation therapy". Therapeutic Advances in Respiratory Disease. 8 (5): 150–61. doi:10.1177/1753465814542243. PMID 25013223. S2CID 32383294.

[1] Wright, BM; Eiland EH, 3rd; Lorenz, R (March 2013). "Augmentation with atypical antipsychotics for depression: a review of evidence-based support from the medical literature". Pharmacotherapy. 33 (3): 344–59. doi:10.1002/phar.1204. PMID 23456734. S2CID 2421659.{{cite journal}}: CS1 maint: numeric names: authors list (link)

[2] Begemann, MJ; Dekker, CF; van Lunenburg, M; Sommer, IE (November 2012). "Estrogen augmentation in schizophrenia: a quantitative review of current evidence". Schizophrenia Research. 141 (2–3): 179–84. doi:10.1016/j.schres.2012.08.016. PMID 22998932. S2CID 40584474.

[3] Zhu, C; Wang, G; Li, J; Chen, L; Wang, C; Wang, Y; Lin, P; Ran, H (November 2014). "Adenosine A2A receptor antagonist istradefylline 20 versus 40 mg/day as augmentation for Parkinson's disease: a meta-analysis". Neurological Research. 36 (11): 1028–34. doi:10.1179/1743132814y.0000000375. PMID 24725292. S2CID 206852879.

[4] Campos, MA; Lascano, J (October 2014). "α1 Antitrypsin deficiency: current best practice in testing and augmentation therapy". Therapeutic Advances in Respiratory Disease. 8 (5): 150–61. doi:10.1177/1753465814542243. PMID 25013223. S2CID 32383294.

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