Double-Blind Comparison of Intravenous Versus Oral Maprotiline*. Antidepressant Activity, Plasma Levels, Side-Effects

Self-Rating Procedures in the Evaluation of Antidepressants

“…This result might be explained by the fact that the items included in each of these measures do not closely corre spond with one another [36], Some investigations demonstrate that there is a general tendency for correlations between self-report and interview scales to be substantially higher for ratings after improve ment of psychopathology than during the peak of a depressive episode [13,24,28,37,38], This was found in our own study, too, when comparing the correlations at discharge and at admission (see table 1). Based on data of another study, in which the efficacy of two antidepressive treatments was evaluated by weekly ratings of depression [39], we could demonstrate an increase of the correlation scores over time ( fig. 1).…”

“…Some data from our own studies using the AMS ( fig. 3) can dem onstrate this point [39,60,76,77], In general, group-statistical results gave no evidence that rating by psychiatrists detects earlier therapeutic response or differences in therapeutic response than self-rating does or vice versa. However, also such results have been reported [58].…”

“…There is a lot of evidence that self-rating depression scales are sensitive to change un der treatment conditions and there is some evidence that they are even sensitive to differ entiation between different kinds of treat ment [38,39,[61][62][63][64][65][66][67][68], However, the literature is not explicit and few direct comparisons have been reported [cf. 2,3,13,20,29,[69][70][71][72], In a review of self-rating evaluation of antidepressants [71], a self-rating of global im provement appeared as the most sensitive self-rating measure of change.…”

Intravenous antidepressants: A review

“…administration appears to be primarily related to the drug used. In the case of maprotiline [Kissling et al, 1985], oral administration was found to be more advantageous. For amitryptiline [Deisenhammer et al, 2000], no significant differences were reported between oral, i.v., and high-dose i.v.…”

Options when anti-depressants cannot be used in conventional ways. Clinical case and review of literature

“…It is thought that IV antidepressants would have faster onset of action and greater efficacy. Studies have been conducted with IV formulations of citalopram [29][30][31] amitriptyline [32], mirtazapine [33,34], clomipramine for obsessive-compulsive disorder [35][36][37] and maprotiline [38,39]. These studies showed some trends, but overall there were no statistically significant results favoring IV formulations over oral in terms of efficacy, tolerability, or onset of action.…”