A Comparative Trial of Desipramine and Nortriptyline in Depression

Abstract

Seven drugs of the imino-dibenzyl group are now generally available in Great Britain (imipramine, amitriptyline, desipramine, nortriptyline, protriptyline, trimipramine and opipramol). All are similar in their actions and side-effects. Imipramine, the first to appear, has been shown to be more effective than placebo in the treatment of depression, though with much better results in men than in women (M.R.C. Clinical Trial, 1965). Desipramine, a metabolite of impramine, was introduced with the claim that its action was quicker than that of imipramine, though this has never been clearly demonstrated. Trials of desipramine against imipramine (Waldron and Bates, 1965; Rose and Westhead, 1964) showed no significant difference between these drugs. Comparison of amitriptyline and imipramine (Burt, Gordon, Holt and Hordern, 1962), showed amitriptyline to be at least as effective as imipramine and significantly superior in the treatment of endogenous depression. Comparisons of nortriptyline and amitriptyline (Forrest, Affleck, Gibb and Priest, 1964; Rose, Leahy, Martin and Westhead, 1965) showed no significant difference between these drugs.

A selective test for antidepressant treatments using rats bred for stress-induced reduction of motor activity in the swim test

“…The adequacy of this procedure was confirmed by measurement of blood levels of antidepressant, which verified that drug was present in circulation at the time of testing. Thus, the model described here responds to chronic but not to acute administration of antidepressant drugs and thus parallels what is seen in the human (e.g., Stewart and Mitchell 1968;Heller et al 1971;reviewed in Katz et al 1996reviewed in Katz et al /1997). However, it should be mentioned that this is not necessarily an advantage of the present technique for screening antidepressant treatments.…”

Correlation of Subjective Side Effects with Plasma Concentrations of Nortriptyline

“…Side effects of tricyclic antidepressant drugs are often reported in connexion with evaluations of their therapeutic efficacy-for example, Rose et al (1965) and Stewart and Mitchell (1968). Some of the side effects attributed to the drug, such as dryness of mouth, constipation, and fatigue, are, however, also well-recognized symptoms of depression.…”

Double‐blind comparison of doxepin and desipramine in patients with primary affective disorder

“…In a similar review of DMI studies up to 1974, this drug was equally efficacious to IMI in nine of 11 studies ( Morris & Beck (1974)), equal to nortriptyline in two ( Haider (1968), Stewart & Mitchell (1968), and to protriptyline in another (Morris & Beck (1974)). Patient diagnoses were heterogeneous in these studies and dosage schedules varied widely.…”