An evaluation of continuation therapy with tricyclic antidepressants in depressive illness

1973 ◽  
Vol 3 (1) ◽  
pp. 5-17 ◽  
Author(s):  
R. H. S. Mindham ◽  
C. Howland ◽  
Michael Shepherd
Keyword(s):  
Antidepressant Medication ◽  
Complete Recovery ◽  
Depressive Illness ◽  
Tricyclic Antidepressant ◽  
Trial Period ◽  
Double Blind ◽  
Residual Symptoms ◽  
Continuation Therapy ◽  
Double Blind Clinical Trial ◽  
Lower Dose Level

SynopsisA double-blind clinical trial has been carried out to ascertain whether patients making a good recovery from depressive illness with tricyclic antidepressant medication derive any benefit from continuation of therapy with the same drug at a lower dose level. Of the 92 patients who entered the trial significantly fewer on active treatment relapsed during the six-month trial period: 22% as compared with 50% of patients receiving placebo. Patients with residual symptoms on entry to the trial derived more benefit from continuation therapy than patients who had made a complete recovery. The findings relate to a six-month trial period only, and any possible advantage of continuation therapy over a longer period remains uncertain.

Continuation Therapy with Amitriptyline in Depression

1978 ◽  
Vol 133 (1) ◽  
pp. 28-33 ◽  
Author(s):  
A. Coppen ◽  
K. Ghose ◽  
S. Montgomery ◽  
V. A. Rama Rao ◽  
J. Bailey ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Plasma Concentrations ◽  
Antidepressant Medication ◽  
Depressive Illness ◽  
Continuation Therapy ◽  
One Year ◽  
To Receive

SummaryThirty-two patients who had responded to amitriptyline (150 mg daily) when suffering from a depressive illness were allocated either to receive placebo or to remain on the same medication for one year.Plasma concentrations of the drug were regularly estimated. There was no correlation between plasma concentration and subsequent residual affective morbidity. In spite of considerable encouragement, three of the patients did not take the prescribed amitriptyline and they all relapsed. Five out of sixteen patients who received placebo relapsed. None of the patients who continued to take amitriptyline relapsed.It is emphasized that the patients studied were selected, inasmuch as they were apparent responders to amitriptyline. It is concluded that this group of patients should continue to be treated with antidepressant medication for eight months after apparent recovery, and care should be taken to ensure the patients' compliance.

Erythrocyte membrane cation carrier, relapse rate of manic-depressive illness and response to lithium

1976 ◽  
Vol 6 (2) ◽  
pp. 257-263 ◽  
Author(s):  
G. J. Naylor ◽  
D. A. T. Dick ◽  
E. G. Dick
Keyword(s):  
Erythrocyte Membrane ◽  
Affective State ◽  
Sodium Concentration ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Double Blind ◽  
Clinical Events ◽  
Manic Depressive ◽  
Double Blind Clinical Trial ◽  
Before And After

SynopsisBiochemical studies of manic-depressive psychosis usually correlate biochemical findings with current affective state and hence any significant findings could be secondary to mood change. The present study attempts to correlate measures of the erythrocyte membrane cation carrier with clinical events, remote in time from the biochemical assay.Erythrocyte sodium concentration, ouabain-sensitive potassium influx and Na-K ATPase were estimated in 11 patients before and after the cross-over point in a 2-year double blind clinical trial of lithium. Patients with the lowest erythrocyte Na-K ATPase and the highest flux sodium ATPase ratio tended to suffer most episodes of affective illness in the 2 years. Patients who had a low initial Na-K ATPase or a high initial flux sodium ATPase ratio, or in whom this ratio fell most with lithium or whose Na-K ATPase rose most with lithium, clinically responded best to lithium.

Lithium Continuation Therapy Following Electroconvulsive Therapy

1981 ◽  
Vol 139 (4) ◽  
pp. 284-287 ◽  
Author(s):  
A. Coppen ◽  
M. T. Abou-Saleh ◽  
P. Milln ◽  
J. Bailey ◽  
M. Metcalfe ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Depressive Illness ◽  
High Rate ◽  
Double Blind Trial ◽  
Double Blind ◽  
Blind Trial ◽  
Clinical Recovery ◽  
Continuation Therapy ◽  
One Year ◽  
To Receive

SummaryThirty-eight depressed patients who were treated with ECT were randomly assigned to receive lithium therapy or identical-looking placebo tablets for one year after clinical recovery in a double-blind trial. The patients who received placebo tablets spent an average of 7.8 weeks with an episode of depression (either as in-patients or day-patients) during the year. In comparison, patients who received lithium spent on average 1.7 weeks with an episode (P <0.02). The trial confirms the high rate of relapses after ECT and suggests that lithium considerably reduces this morbidity. It is suggested that ECT without continuation therapy is not a satisfactory treatment of depressive illness.

Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind, controlled trial

1984 ◽  
Vol 14 (1) ◽  
pp. 37-50 ◽  
Author(s):  
A. I. M. Glen ◽  
A. L. Johnson ◽  
M. Shepherd
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Detailed Analysis ◽  
Controlled Trial ◽  
Depressive Illness ◽  
Double Blind ◽  
Prophylactic Efficacy ◽  
Continuation Therapy ◽  
Significant Difference ◽  
Clinically Significant

SynopsisA detailed analysis of the results of a multi-centre clinical trial shows that, while the relapse rate following recovery from an operationally defined depressive illness was smaller among patients subsequently treated with either amitryptiline or lithium than with a placebo, there was no clinically significant difference between the prophylactic efficacy of the 2 antidepressants. An account is given of the relative adverse effects of the treatments, and the implications of the findings are discussed.

A Controlled Trial of the Therapeutic Effects of Polarization of the Brain in Depressive Illness

1964 ◽  
Vol 110 (469) ◽  
pp. 786-799 ◽  
Author(s):  
R. Costain ◽  
J. W. T. Redfearn ◽  
O. C. J. Lippold
Keyword(s):  
Clinical Trial ◽  
Human Subjects ◽  
Controlled Trial ◽  
Depressive Illness ◽  
Therapeutic Effects ◽  
Double Blind ◽  
Beneficial Effects ◽  
Double Blind Clinical Trial ◽  
The Brain

A previous paper (Lippold and Redfearn, 1964) described various mental changes which occur when small direct currents are passed through the brain in human subjects. Some beneficial effects often followed this procedure and it appeared worthwhile to carry out a controlled double-blind clinical trial.

How Long Should the Elderly Take Antidepressants?

1993 ◽  
Vol 162 (2) ◽  
pp. 175-182 ◽  
Author(s):  
◽  
Robin Jacoby ◽  
A. Daniel Lunn ◽  
M. Ardern ◽  
K. Bergmann ◽  
...  
Keyword(s):  
Relative Risk ◽  
Controlled Trial ◽  
Antidepressant Medication ◽  
The Elderly ◽  
Depressive Illness ◽  
Favourable Outcome ◽  
Elderly Persons ◽  
Major Depressive ◽  
Double Blind ◽  
Risk Of Relapse

Of 219 elderly patients with a major depressive disorder (meeting RDC), 69 recovered sufficiently and consented to enter a two-year double-blind placebo-controlled trial of dothiepin. Survival analysis revealed that dothiepin reduced the relative risk of relapse by two and a half times. Past but not current serious physical illness was also associated with a favourable outcome, whereas a prolonged index depressive illness trebled the relative risk of relapse. In the light of previous research on prognosis it is suggested that elderly persons who recover from a major depressive illness should continue with antidepressant medication for at least two years, if not indefinitely.

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