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Abstract
The treatment of resistant depression has involved the use of various adjuncts in addition to the antidepressant, such as lithium or liothyronine (T3). This case report describes a woman with a history of chronic depression (dysthymic disorder), unresponsive to a number of traditional antidepressants, who was treated with the antidepressant bupropion and the nutritional and herbal supplements inositol and ginkgo. Her bupropion was able to be reduced, and she appeared to respond well to the added supplements, reducing her Ham-D score from 17 to 11. In this case, it was hypothesized that the inositol was the probable active adjunct with regard to the antidepressant effect, with the ginkgo helping with cognition. The inositol theory is reviewed with reference to mania and depression.