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 .
Fluoxetine in tricyclic refractory major depressive disorder.
Data regarding open-label treatment with fluoxetine following failure to respond to tricyclic antidepressants ( TCAs ) or intolerance of TCA side effects , suggest a response rate between 51.4 % and 62.1 % , depending on the definition of TCA refractoriness employed . Double-blind study of this issue would extend these findings . Fluoxetine is well tolerated in patients unable to tolerate TCAs .  Within this population , more than 80 % of patients unable to tolerate TCAs found fluoxetine acceptable . Fluoxetine , as an alternative to polypharmaceutical augmentation , may represent a logical choice as the next step in therapy for a patient who has initially been treated with a TCA and has proven refractory or intolerant
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 .