What Is Combination Drug Therapy (or Combined Therapy)?

Combination drug therapy is also referred to as "combined therapy" (which may also refer to the use of medications and other forms of therapy) or "polypharmacy".  When the later term is used, it is with the suggested that this is a practice that should be avoided.  Nothing could be further from the truth.

Combined (or combination) drug therapy involves the use of two or more medications to treat a specific illness.  There are two reasons why this strategy might be applied.  

The first is that the combination of drugs may "augment one another", that is, they can potentially provide greater improvement in symptoms than any of the drugs can by themselves.  The second reason is that by using two or more drugs in lower doses, troublesome side effects can often be reduced or avoided altogether.

Combined therapy is what has allowed us to dramatically improve patients' response to drug therapy in the areas of cancer chemotherapy, the treatment of AIDS (Acquired Immunodeficiency Syndrome), the treatment of drug resistant infections, and the treatment of a variety of mental illnesses.

It is true that it's more difficult to determine whether or not any given drug is helping when the patient is taking two or more medications.  It is also true that it is more difficult to decide which drug or drugs are causing side effects.  Neither of these facts should discourage a doctor from trying combinations of drugs.  The ultimate goal is for the patient to improve as much as possible.  In our efforts to accomplish this goal, we should not avoid potentially helpful strategies,  simply because they may be more difficult.

The concern about the number of drugs a patient is taking is justified when either the patient or the doctor lose sight of whether or not the addition of another drug has been helpful.  It is also a concern when side effects are accumulating and they begin to outweigh the benefits of the medications the patient is taking.

Discovering the precise "cocktail" of medications that is most helpful for each patient is a process.  It is generally a process that takes time; enough time to allow for careful changes in medications and to be sure that each change is both helpful and without intolerable side effects.  This requires patience, trust, and quality communication between patients and their doctors.  If those requirements are met, patients stand the best chance of enjoying the most benefit from their medications.