Combinations of antidepressants with both serotonergic and noradrenerg
ic activity may be especially effective and thus useful in treating re
fractory patients and severely depressed patients. In the current repo
rt, studies of combinations of serotonin selective reuptake inhibitors
(SSRIs) and noradrenergic tricyclics or of SSRIs and bupropion are re
viewed, and practical issues pertaining to their use are discussed.