A Comparison of Nortriptyline and Amitriptyline in Depression

Abstract

Nortriptyline (Allegron, Aventyl) is the demethylated metabolite of amitriptyline. Preliminary trials by Bennett (1962), Oltman et al. (1963) and Leahy et al. (1964) indicated that it might be an effective anti-depressant. Forrest et al. (1964) found that it compared favourably with amitriptyline, a widely used anti-depressant of established efficacy. This investigation also compares nortriptyline with amitriptyline.

Factorial structure of the Hamilton rating scale for depression

“…When the two samples were combined, the resultant factor structure remained basically unchanged, except that the fifth factor, somatic concerns, clearly emerged as an identifiable dimension. response to a growing need to measure the severity of a depressive episode, and has been found to be particularly useful in assessing the effects of antidepressant medication over the course of a depressive illness (Dykstra, 1969;Knesevich, et al, 1977;Rose, et al, 1965).…”

“…Diurnal variation (18), while not contributing to the overall severity score per se, was included because it indicated type of illness---depressions that were described as being worse in the morning but better in the evening were typically assumed to be endogenous, a type of depression thought to be biological in nature, relatively independent of environmental influences and with probable genetic components. Considered to occur too infrequently to be included in the rating of symptom severity, but thought by Hamilton to be important for research purposes the last three items added to the scale were: (19) Derealization and Since its appearance, the HRS has proven to be an invaluable clinical and research tool in the assessment of severity of depression and change during treatment (Dykstra, 1969;Hamilton, 1960;Knesevich, Biggs, Clayton, & Ziegler, 1977;Rose, Leahy, Martin, & Westhead, 1965;Waldron & Bates, 1965), as well as in factor analytic studies attempting to differentiate types of depression or symptom clusters (Hamilton & White, 1959;Mowbray, 1972;Weckowicz, Cropley, & Muir, 1~71).…”

Treatment of Depression and Anxiety in General Practice

“…‘Depressive illness is the commonest psychiatric condition in general practice.‘ (Pollitt , 1965). A close rival, in the experience of most general practitioners, must be anxiety; and it is now widely accepted (Ayd 1961; Rose et al 1965) that these conditions in fact usually occur together. Thus the overtly depressed patient is usually anxious, tense or agitated as well, while in the predominantly anxious patient an underlying depression can often be discerned if care is taken to look for it.…”