Table 45-3 Clinical trials of combination strategies in unipolar depression

Table 45-3 Clinical trials of combination strategies in unipolar depression
Investigators	N	Design	Failed trial	Daily dosage	Response rate
MAOI+TCA
Sethna 1974	12	Open	TCA, MAOI	75 mg amitriptyline; 45 mg phenelzine	83%
Davidson et al. 1978	17	RCT	Adequate trial with conventional treatments	20-100 mg amitriptyline; 15-45 mg phenelzine	Combination less effective than ECT
Riise and Holm 1984	27	Open	MAOI or TCA alone	0.5 mg/kg isocarboxazid; 30-90 mgmianserin	74%
Feigner et al. 1985	11	Retrospective	2-year history of MAOI and TCA treatment resistance	5-15 mg MAOI; 15-400 mg TCA	64%
Schmauss et al. 1988	94	Retrospective	Two or more trials of TCA or tetracyclic antidepressant	10-30 mg tranylcypromine; 50-300 mg TCA	68%
SSRI+TCA
Weilburg et al. 1989	30	Retrospective	Non-MAOI	20-60 mg fluoxetine; 37.5-400 mg TCA	87%
Weilburg et al. 1991	20	Retrospective	Fluoxetine alone	20-40 mg fluoxetine; 10-100 mg TCA	65%
M. Fava et al. 1994b	41	RCT	Fluoxetine alone	20 mg fluoxetine plus 25-50 mg desipramine vs. 40-60 mg fluoxetine	Combination less effective than raising dose
Levitt et al. 1999	13	Open	Fluoxetine and desipramine or imipramine	20 mg fluoxetine; 1 mg/kg desipramine orimipramine	31%
Note. MAOI = monoamine oxidase inhibitor; TCA = tricyclic antidepressant; RCT = randomized clinical trial; ECT = electroconvulsive therapy; SSRI = selective serotonin reuptake inhibitor.