SSRIs Venlafaxine Augmentation strategies TCAs MAOIs SSRIs Venlafaxine Moret Reboxetine Desipramine Venlafaxine SSRIs Various Various TCA Fluoxetine Fluoxetine Paroxetine Fluoxetine Paroxetine Citalopram Fluoxetine Nefazodone Fluvoxamine MAOIs Citalopram Fluoxetine Paroxetine Citalopram Sertraline Milnacipran 306 Bupropion Mirtazapine Bupropion-SR ECT Psychotherapy Lithium Valproate Carbamazepine Lamotrigine Thyroid hormone Pindolol Buspirone Estrogen Metyrapone Olanzapine Ziprasidone Risperidone SAME DA boost Open trial (Alpert et al 2004) Methylphenidate DA boost Supposed mechanism of action Prevention of side-effects by blockade of 5-HT2A/C receptors Catecholamine boost 5-HT and boost 5-HT, and DA boost Probably stimulation of common pathways Probably stimulation of common pathways Type of study (reference) Retrospective prescription analysis (Clark and Alexander 2000) Review (Stahl 2000) (theoretical) Prospective and randomized trial (Rush et al 2004) Naturalistic, open-label cohort study (Lam et al 2004) Uncontrolled clinical series (Bodkin et al 1997); open case series (Ramasubbu 2002) Retrospective case-controlled study (Gagné et al 2000) Randomized, comparative study (Keller et al 2000); meta-analysis (Thase et al 1997); randomized, comparative 2-year follow-up study (Fava et al 1998); open 2-year follow up trial (Fava et al 1997); randomized, comparative 2-year follow up study (Fava et al 1994); controlled trial (Paykel et al 1999); randomized, double- blind, placebo-controlled trial (Reynolds et al 1999) Second messenger system boost 5-HT boost Correction of endocrine dysfunction Blockade of 5-HT1A autoreceptors (feedback removal) Stimulation of postsynaptic 5-HT1A receptors Correction of estrogen fluctuations Inhibition of cortisol synthesis (high in depression) Blockade of 5-HT2A receptors Stimulation of 5-HT1A receptors boost Review (Bauer et al 2003); open trial (Bertschy et al 2003); review (Dietrich and Emrich 1998); randomized, double-blind, placebo- controlled study (Barbosa et al 2003); open study (Ciusani et al 2004) Randomized, double-blind, placebo-controlled study (Joffe et al 1993); meta-analysis (Altshuler et al 2001); open-label treatment (Agid and Lerer 2003) Meta-analysis (Ballesteros and Callado 2004); review (Isaac 2004); review (Artigas et al 2001); controlled trial (Pérez et al 2001); placebo-controlled study (Sokolski et al 2004); double-blind, placebo-controlled trial (Berman et al 1997) Open trial (Dimitriou and Dimitriou 1998); review (Shayegan and Stahl 2000); randomized, double-blind, placebo-controlled study (Appelberg et al 2001); randomized, double-blind, placebo- controlled study (Landen et al 1998) Open trial (Rasgon et al 2002); randomized, comparative study (Westlund and Parry 2003); randomized, open-label, parallel trial (Liu et al 2004) Double-blind, placebo-controlled trial (Jahn et al 2004) Review (Feinberg 2004); case study (Shelton Clauson 2004); open-label trial (Lavretsky et al 2003) Double-blind, comparative study (Shelton et al 2001); retrospective chart review (Barbee et al 2004); open trial (Papakostas et al 2004); case series (Tani et al 2004); case series (Ostroff and Nelson 1999) Table 2 List of combination/augmentation strategies Antidepressants Adjunct Antidepressant combinations SSRIs Trazodone Nefazodone Abbreviations: DA, dopamine; ECT, electroconvulsive therapy; NA, noradrenaline; SAME, S-adenosyl-l-methionine; SSRIs, selective serotonin reuptake inhibitors. Neuropsychiatric Disease and Treatment 2005:1(4)