A literature review of antidepressant combination therapyLithium and tricyclic augmentation of fluoxetine treatment for resistant major depression: a double-blind, controlled studyDouble-blind study of high-dose fluoxetine versus lithium or desipramine augmentation of fluoxetine in partial responders and nonresponders to fluoxetineTricyclic antidepressant pharmacology and therapeutic drug interactions updatedCombined treatment with venlafaxine and tricyclic antidepressants in depressed patients who had partial response to clomipramine and imipramineSelective serotonin reuptake inhibitors combined with venlafaxine in depressed patients who had partial response to venlafaxine: four casesProgress in Neuro-Psychopharmacology and Biological PsychiatryVenlafaxine–mirtazapine combination in the treatment of persistent depressive illnessElectroconvulsive therapy in depressive illness that has not responded to drug treatmentLow-dose trazodone as a hypnotic in patients treated with MAOIs and other psychotropics: a pilot studyCombination therapy using moclobemide with tricyclic and tetracyclic antidepressants to treat therapy-resistant depressionSelective serotonin reuptake inhibitor-induced serotonin syndrome: reviewCombined treatment with imipramine and mianserin.

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Despite an increase in the number of available and effective antidepressants, many patients with depression respond poorly to drug treatment. Sleep quality and duration and side‐effects were assessed at baseline and every treatment day. In due course, desensitisation of these autoreceptors enhances serotonin neurotransmission. Nightmares and vivid dreams are side effects of several popular medications. The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study has been a welcome addition and provides evidence for a variety of options for up to four failed treatment trials ( This article is based on searching the literature indexed in MEDLINE and published in English since 1950. Hypomanic switches were reported in the RCT group of in-patients with treatment-resistant major depression ( There are two double-blind controlled studies of TCAs used in combination with mianserin ( As far as we are aware, there are no studies that investigate the combination of TCAs with mirtazapine, although the principles behind the combination would be similar to those for mianserin. Weight gain and sedation may be prominent and related to mirtazapine. The SSRI–SSRI combination has only been tried in two open-label studies ( Nausea and tremor are common with the citalopram–fluvoxamine combination but no serious side-effects were noted from either reported series. The SSRI–SNRI and TCA–SNRI combinations have been considered in the previous sections. Not every combination used clinically has a sound neuropharmacological rationale and the use of such combinations may increase the side-effect burden without any additional advantage to the patient. Desipramine and venlafaxine may act via different noradrenergic reuptake mechanisms and systematic trials of this combination have been encouraged ( Reported side-effects with the combination include mild hypersomnia, sexual dysfunction after dose increases, constipation and weight gain. Effects on performance were much less than those seen in other studies after administration during the day. A controlled pilot studyDo depressed subjects who have failed both fluoxetine and a tricyclic antidepressant respond to the combination?Reboxetine combination in treatment-resistant depression to selective serotonin reuptake inhibitorsInteractions between sertraline and tricyclic antidepressantsEfficacy of treatment with trazodone in combination with pindolol or fluoxetine in major depressionTranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D reportMianserin added to tricyclic antidepressants in depressed patients not responding to a tricyclic antidepressant aloneNational Institute for Health and Clinical ExcellenceDepression: Management of Depression in Primary and Secondary CareCombining norepinephrine and serotonin reuptake inhibition mechanisms for treatment of depression: a double-blind, randomized studyManagement of monoamine oxidase inhibitor-associated insomnia with trazodonePossible trazodone potentiation of fluoxetine: a case seriesThe efficacy and tolerability of combined antidepressant treatment in different depressive subgroupsAdverse drug reactions in combined tricyclic and MAOI therapyFatal interaction between tranylcypromine and imipramineCombined pharmacotherapy and psychological treatment for depression: a systematic reviewAugmentation of antidepressants with atypical antipsychotic medications for treatment-resistant major depressive disorder: a meta-analysisTreatment of SSRI-resistant depression: a meta-analysis comparing within- versus across-class switchesTherapeutic drug monitoring of trazodone: are there pharmacokinetic interactions involving citalopram and fluoxetine?International Journal of Clinical Pharmacology and TherapeuticsFluoxetine–mirtazapine interaction may induce restless legs syndrome: report of 3 cases from a clinical trialThe safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatmentReboxetine adjunct for partial or nonresponders to antidepressant treatmentCombination of tricyclic antidepressants with moclobemide or tranylcypromine – outcome data in therapy resistant MDMoclobemide and amitriptyline, alone or in combination, in therapy resistant depressionHuman Psychopharmacology: Clinical and ExperimentalFluoxetine added to non-MAOI antidepressants converts nonresponders to responders: a preliminary reportFluoxetine-induced tricyclic toxicity: extent and durationCombined MAOI-tricyclic antidepressant treatment: a controlled trialControlled trial of trimipramine, monoamine oxidase, and combined treatment in depressed outpatients