Amitriptyline is an efficacious antidepressant drug .
It is , however , also associated with a number of side effects .
Degree of placebo response and severity of depression at baseline may moderate drug-placebo efficacy differences
BACKGROUND Amitriptyline is a tricyclic antidepressant that was synthesis ed in 1960 and introduced as early as 1961 in the USA , but is still regularly used .
It has also been frequently used as an active comparator in trials on newer antidepressants and can therefore be called a ' benchmark ' antidepressant .
However , its efficacy and safety compared to placebo in the treatment of major depression has not been assessed in a systematic review and meta- analysis .
OBJECTIVES To assess the effects of amitriptyline compared to placebo or no treatment for major depressive disorder in adults .
PREDICTORS OF AMITRIPTYLINE RESPONSE IN OUTPATIENT DEPRESSIVES
A step- search multiple regression procedure was applied to data obtained from 120 amitriptyline-treated and 138 placebo-treated depressed nonpsychotic out patients in order to : 1 ) assess the magnitude of the drug 's effect in an outpatient sample after the possibly contaminating effects of relevant sources of patient heterogeneity have been statistically removed and 2 ) identify predictors of response to amitriptyline , placebo , or both . Patient , illness , and treatment attributes deemed of possible relevance were employed as potential predictors . Patients were drawn from two city hospital clinics and the private practice s of both general practitioners and private psychiatrists . The double blind drug trial employed was of 4 weeks ' duration , and improvement was assessed through both a patient global rating of change and a pretreatment-post-treatment difference in physicianevaluated depressive psychopathology ( PDS improvement ) . The drug effect was highly significant . Its magnitude was left unchanged for global improvement and slightly enhanced for PDS improvement when possibly contaminating influences of other predictors were statistically controlled through the regression procedure . For both improvement measures , drug-placebo differences were greater in more severely than in less severely ill patients . For all patients , irrespective of treatment agent , acute illness 6 months ) responded better to treatment than did long term illness . For the global measure there were indications that the more adequate personal and social re sources , as well as the more favorable and realistic attitudes , of the higher socioeconomic class patient were instrumental in effecting greater  drug-placebo differences than occurred for patients of lower socioeconomic class affiliation . Finally , in replication of previous results , placebo patients were found to show greater global improvement when their physicians reported liking them less
Amitriptyline is an efficacious antidepressant drug .
It is , however , also associated with a number of side effects .
Degree of placebo response and severity of depression at baseline may moderate drug-placebo efficacy differences
BACKGROUND Amitriptyline is a tricyclic antidepressant that was synthesis ed in 1960 and introduced as early as 1961 in the USA , but is still regularly used .
It has also been frequently used as an active comparator in trials on newer antidepressants and can therefore be called a ' benchmark ' antidepressant .
However , its efficacy and safety compared to placebo in the treatment of major depression has not been assessed in a systematic review and meta- analysis .
OBJECTIVES To assess the effects of amitriptyline compared to placebo or no treatment for major depressive disorder in adults .