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 .
CLINICAL RESPONSE TO AMITRIPTYLINE AMONG DEPRESSED WOMEN
Eighty-five female depressed patients were treated for 4 weeks with amitriptyline in a flexible dose ( median , 150 mg daily ) . Predictive analyses of outcome were carried out , using both typological and regressional models based on the same 29 predictor variables . The typological prediction utilized a previously described four-group typology derived by multivariate cluster analysis and comprising psychotic depressives , anxious depressives , hostile depressives , and young depressives with personality disorder . Patients were assigned to groups by discriminant functions on the basis of scores on the predictor variables . The four groups were found to predict outcome significantly . Psychotic depressives , initially the most severely depressed , improved the most ; anxious depressives , a little less severely ill initially , showed the least improvement and the most residual illness at 4 weeks ; hostile depressives and young depressives with personality disorders , initially the least severely ill , showed intermediate improvement and were least ill , by a small margin , at 4 weeks . The 29 predictor variables also predicted outcome significantly in linear multiple regression analyses . Five variables showed regression weights significantly different from zero : high initial severity predicted high improvement but more residual illness ; initial insomnia , more previous depressions , longer illness , and hypochondriasis all predicted low improvement and more residual illness . Predictions by using typological and regression models were compared , and their interrelationships were examined . The regression prediction accounted for more variance in outcome measures than did the typology , but the statistical significance s of the regression and typological predictions were of the same order . Two variables appeared particularly important — high initial severity of illness which characterized the psychotic depresives and increased number of previous depressions which characterized the anxious depressives . Typological prediction was not solely due to these two variables in linear regression model sicne it remained significant when the outcome measure was adjusted for both by analysis of covariance . Both typological and regressional models provide useful approaches to prediction , with only limited overlap . The typological approach , which has been relatively neglected in recent years , warents more frequent application as an alternative to multiple regression
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 .