background Treatment of depressed outpatients with a combination of psychotherapy and medication could have important advantages.
aims The authors hope to answer the question if combination therapy is the most effective treatment for depressed outpatients.
method A search in Medline was performed in combination with available reviews and crossreferences.
results Eighteen studies were found. Overall there was no advantage for combined treatment. For a particular subgroup of patients with a longer duration of the index episode, more severe or more complex symptomatology, combination treatment could be more effective than either treatment alone.
conclusions Due to methodological problems of all the studies found no definitive judgment on the value of combination treatment can be made. More research in this area is needed, because combination treatment could very well have advantages besides improving outcome in areas as quality of life and improvement of treatment compliance.