The combination of duloxetine and bupropion for treatment-resistant major depressive disorder

Our objective was to assess the effectiveness and safety of the combination of duloxetine and bupropion for treatment‐resistant major depressive disorder (TRD). A retrospective chart review was conducted to identify patients with major depressive disorder (MDD) who had not experienced full remission of symptoms following an adequate trial of either duloxetine (n=3) or bupropion (n=7), and who then received the combination of these two antidepressants for TRD. Ten patients [37.2±11.3 years of age, five women, baseline Clinical Global Impressions (CGI) scale score 4.4±1.1], seven of whom had not remitted following treatment with bupropion (330±67 mg, 20.5±12.2 weeks), and three of whom had not remitted following treatment with duloxetine (90±30 mg, 18±2 weeks) received at least 4 weeks of combination treatment. The CGI was administered when the combination was first prescribed, and following 8.8±4.0 (range, 4–16) weeks of treatment. There was a significant decrease in CGI‐S (Severity) scores (4.4±1.1 to 2.1±0.9, P