At first a history of development of antidepressants is mentioned. Dual-acting antidepressants are a relatively recent class of antidepressants. They include both serotonin and norepinephrine reuptake inhibitors (SNRI), e.g. venlafaxine, milnaciprane and duloxetine and a representative of noradrenergic and specific serotonergic antidepressants (NaSSA) mirtazapine. Further individual dualacting antidepressants are compared including pharmacological profile, pharmacokinetics, efficacy and side effects. In some studies their profile of effectiveness was comparable to tricyclics and higher than SSRIs. They are better tolerated than tricyclics and similar to SSRIs. They have also a higher rate of remissions and according to some studies it seems that they have a faster onset of efficacy. Finally new indications of dual-acting antidepressant are cited, e.g. anxiety disorders and pain including depression associated pain.

        Key words: dual-acting antidepressants, venlafaxine, milnaciprane, duloxetine, mirtazapine, efficacy, tolerability, indication.