[Lithium carbonate augmentation in tricyclic antidepressant-resistant depression]

Combinations of lithium carbonate and tricyclic antidepressants are effective in the treatment of resistant unipolar depression. We present a case in which addition of lithium carbonate to a maximal dose of desipramine provided rapid and sustained improvement in a severely depressed 57-year-old woman. She had previously failed to respond to maximum doses of antidepressant drugs of 2 different classes. Although the lithium-tricyclic combination was successful in our case, we caution against its routine use.