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 .
A double‐blind, placebo‐controlled study comparing mianserin and amitriptyline in moderately depressed outpatients
We report on the results of a study comparing mianserin with amitriptyline and placebo , in out patients with major depression ( DSM-III 296.2 or 296.3 ) . One hundred and forty-nine patients were r and omized to mianserin ( n = 50 ) , amitriptyline  ( n = 50 ) or  placebo  ( n = 49 ) . Medication was taken in a nightly ( qhs ) dose . During Week 1 , the maximum dose was 60 mg mianserin , 120 mg amitriptyline or two placebo capsules . Beginning at Day 7 ( through Day 42 ) maximum dosages were 150 mg mianserin , 300 mg amitriptyline or five placebo capsules . At multiple weeks and endpoint , statistically significant reductions in the Hamilton Depression Scale ( HAM-D ) 17− and 21-item scores were recorded for both active drugs compared with placebo . Positive results with the HAM-D were corroborated by other measures of efficacy . There were no statistically significant differences between mianserin and amitriptyline in terms of efficacy ; however , the results do suggest a more rapid therapeutic response for mianserin compared with amitriptyline , in terms of percentage of patients showing ≥ 50 % improvement at Weeks 2 ( 30 % vs 23 % ) and 4 ( 61 % vs 44 % ) . The most common adverse experiences were somnolence  ( amitriptyline and mianserin 60 % , placebo 31 % ) and dry mouth  ( amitriptyline 76 % , mianserin 30 % and placebo 20 % ) . Our results indicate that mianserin is clearly superior to placebo , compares favorably with amitriptyline , and is a safe , well-tolerated , effective medication in the treatment of depressed out patients
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 .