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More on Combination Antidepressant Therapy

Arch Gen Psychiatry. 1984;41(5):527-528. doi:10.1001/archpsyc.1984.01790160113016.
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To the Editor.—  We read with interest the much-needed recent report by Razani et al1 concerning the efficacy and safety of combined amitriptyline hydrochloride and tranylcypromine sulfate antidepressant treatment. This letter is to reaffirm that safe practice and to report the use of another safe drug combination, phenelzine sulfate and trazodone hydrochloride, in five cases.

Report of Cases.  Case 1.—A 26-yearold divorced woman had "mood swings" and neurovegetative symptoms of depression. The patient did not experience significant symptom amelioration with a course of 175 mg/day of imipramine hydrochloride or of 75 mg/day of nortriptyline hydrochloride with 4 mg of perphenazine three times a day, but did experience urinary retention. Because of the clinical course, as well as a history of mixed drug abuse in adolescence, a diagnosis of "hysteroid dysphoria"2 was considered and 15 mg of phenelzine sulfate three times a day was prescribed. The patient experienced relief


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