Are Two Antidepressant Mechanisms Better Than One?

The classical antidepressants,
namely tricyclic antidepressants
(TCAs) and monoamine oxidase inhibitors, have multiple
pharmacologic mechanisms, but only
those increasing the availability of serotonin
(5-HT) and norepinephrine
(NE) explain antidepressant actions.
Their other actions, such as anticholinergic
properties, are responsible for
side effects.1 This profile has given
rise to the notion that multiple mechanisms
mean "dirty drugs" and that the
best drugs should be "smart bombs"
attacking only a single receptor target.