04. Combining Antidepressants
Key Points
- Based on pharmacological reasoning, clinicians often use two specific antidepressant combinations:
- Mirtazapine + SSRI or SNRI
- Bupropion + SSRI or SNRI
- Even though these interventions have complementary mechanisms of action, the evidence base from actual clinical trials is limited
- When added as a second drug, it is prudent to start at low doses:
- Mirtazapine 15 mg/day
- Bupropion 150 mg/day
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