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Beyond the evidence: is there a place for antidepressant combinations in the pharmacotherapy of depression?

Nicholas A Keks, Graham D Burrows, David L Copolov, Richard Newton, Nick Paoletti, Isaac Schweitzer and John W G Tiller
Med J Aust 2007; 187 (3): . || doi: 10.5694/j.1326-5377.2007.tb01194.x
Published online: 6 August 2007

In reply: The letters by Horgan and Walters et al underline our motive for reviewing antidepressant combinations. The conclusions of the survey are at least questionable, given that the response rate was only 36%, 18% of respondents were not psychiatrists, and affirmative responders may have only used combination antidepressants once.1 In any case, should clinical popularity substitute for evidence? If so, once popular but now research-discredited treatments such as insulin coma therapy would still be used.


  • 1 Monash University, Melbourne, VIC.
  • 2 University of Melbourne, Melbourne, VIC.



  • 1. Horgan D, Dodd S, Berk M. A survey of combination antidepressant use in Australia. Australas Psychiatry 2007; 15: 26-29.<eMJA full text>
  • 2. McGrath PJ, Stewart JW, Fava M, et al. Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report. Am J Psychiatry 2006; 163: 1531-1541.

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