In some past articles and in a couple places online I advocate using a custom memcache/db based php session handler. Lately I have gotten a few people ask me why use both? The complaint being that using both increases overhead.
One of those articles is http://www.cyberlot.net/improving-php-sessions. The main issue people seem to have is number 3.
There are a number of reasons to use both, if your site uses any type of persistence having the sessions in the database will allow your sessions to live through a reboot while memcache only sessions would not!
Another reason is load balancing, Imaging a setup where www is a load balancer that forwards you to a web servers www1 - www9. If your on www9 and you use both DB and memcache sessions when the users leaves and comes back, the load balancer pushes them to www5 there session data still exists, This can be very important depending on the application use.
In the end its all out your needs, Does a simple application really need a DB based/ memcache enhanced session handler? No it doesn't.