An evaluation of continuation therapy with tricyclic antidepressants in depressive illness

Abstract

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.

Double-Blind, Placebo-Controlled Trial of the Use of Lithium to Augment Antidepressant Medication in Continuation Treatment of Unipolar Major Depression

“…The higher percentage of depressive relapses with placebo than with the active drug was in line with rates reported in studies that have examined the efficacy of antidepressant monotherapy during the continuation phase of treatment (35)(36)(37)(38). As reviewed by Prien (22), relapse rates in placebo-controlled continuation therapy trials ranged from 31% to 80% for patients who received placebo, compared with only 0%-31% for patients who received active medication.…”

Factors affecting the consumption of psychotropic drugs

“…This is particularly so for users of hypnotics (Williams & Courtenay, 1979), who constitute nearly 40 % of the psychotropic consumers in this study, (iii) A proportion of drug consumers might be expected to have responded to treatment, and hence no longer be 'cases', although still consuming drugs. While there is not much evidence that long-term tranquillizer therapy is of benefit (White House Office of Drug Policy, 1979), long-term antidepressent treatment is known to be a useful form of management (Mindham et al 1973); antidepressants were taken by 14 % of the consumers in this study.…”

Deliberate self‐harm in the elderly

“…The criteria for the diagnosis of depressive illness were those used in the MRC trial of maintenance treatment for depression (Mindham et al, 1973). Other conditions were classified using the ICD 9 system.…”