Bupropion-Tranylcypromine Combination for Treatment-Refractory Depression

Letter to the Editor

Sir: We report the safe and successful use of combined bupropion
and tranylcypromine in a case of treatment-refractory
depression.

Case report. Ms. A, a 27-year-old woman with chronic major
depression (DSM-III-R criteria), was treated in 1990 at age
17 with imipramine up to 150 mg/day. In March 1994, after a
suicide attempt by imipramine overdose, paroxetine, 20 mg/day,
replaced imipramine. On paroxetine, 30 mg/day, and amitriptyline,
50 mg q.h.s., she experienced only mild improvement at
6 months.