This article qualitatively reviews the comparative efficacy of pharmacotherapy and psychotherapy vs either modality alone. Recent results are confirming AHCPR statements, that, on the basis of current data, in acute treatment of Major Depressive Disorders (MDD), the routine use of both psychotherapy and pharmacotherapy is not warranted. But a methodologically outstanding study from the work-group around Frank shows that, in longterm treatment of MDD-patients, combined psycho-pharmaocotherapy is superior compared to interpersonal psychotherapy alone, but not compared to tricyclics alone. In two settings patients might benefit substantially from a combination treatment compared to both psychotherapy and pharmacotherapy alone: 1) Acute and long-term treatment of more severe chronic depression, and 2) long-term treatment of elderly MDD-patients. More severely depressed MDD-patients profit more and faster if treated with combined psycho-pharmacotherapy compared compared to psychotherapy alone.