Abstract
The addition of low-dose tricyclic antidepressant (e.g., 10-50 mg of DMI) was employed as a treatment adjunct for 20 outpatients with major depressive disorder and/or dysthymia whose response to fluoxetine alone had been inadequate. Retrospective assessment revealed complete resolution of depression (full response) in 13 patients (65%) after adjunct was added. Improvement was evident within seven days of introduction of the adjunct in seven of the responders (54.8%). One patient worsened, experiencing increased agitation. No treatment-emergent side effects were observed in the other 19 patients. TCA plasma levels obtained in nine patients while combination treatment was ongoing were higher than would be expected for that dose of TCA used alone, but none of the levels were in the toxic range.