Low dosage tricyclic antidepressants for depression

Furukawa, Toshi A.; McGuire, Hugh; Barbui, Corrado

doi:10.1002/14651858.cd003197

Cited by 48 publications

(32 citation statements)

References 68 publications

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“…The same strategy could be effective for depression, while OCD will require follow-up with clomipramine at the highest dosage of medication tolerable. In meta-analytic studies, it was found that depressed patients who received a combination of antidepressants and BDZ, had a significantly less likelihood of dropping out from treatment, experienced a significantly greater reduction in symptoms-a difference that was no longer significant at 6 to 8 weeks (Furukawa, Streiner & Young, 2001); and that treatment of depression in adults with relatively low dose of TCAs (75-100 mg) was justified (Furukawa, McGuire & Barbui, 2003).…”

Section: Evidence-based Treatment Options: the Case For Ssris Snri Amentioning

confidence: 99%

The Management of Anxiety and Depressive Disorders: A Review

Ohaeri¹

2006

Int J Ment Health Addiction

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While anxiety and mild-moderate depression (the so-called neuroses) are the commonest mental disorders, they receive scant attention. They should be considered together, because they commonly occur together, are typically chronic, and respond to the same treatment. This review challenges traditional notions about the neuroses, by examining the reasons for their co-morbidity, the effectiveness of SSRIs in anxiety, and the biological basis of anxiety. From neuro-endocrine, psychoimmunology, genetic and clinical studies, anxiety and depression could denote manifestations of an underlying cause. Anxiety results from a dysregulation of homeostasis in the serotonin and noradrenergic systems, which SSRIs stabilize. Treatment guidelines recommend that SSRIs and SNRI should be first-line in the treatment of anxiety disorders, in combination with psychotherapy, with benzodiazepines used on short-term basis. Remission should be the goal of treatment. Outcome should include clinical, functional and disability assessments, graded in terms of response, remission and recovery. Perhaps the SSRIs and SNRI should be recognized as anti-neurotic. Mental disorders probably exist in a biological system with serotonin at the root of the neuroses, while dopamine sub-stands the psychoses.

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Section: Evidence-based Treatment Options: the Case For Ssris Snri Amentioning

confidence: 99%

The Management of Anxiety and Depressive Disorders: A Review

Ohaeri¹

2006

Int J Ment Health Addiction

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“…Selective serotonin reuptake inhibitors (SSRIs)1–3 and tricyclic antidepressants (TCAs)4,5 are common agents for the treatment of major depressive disorder (MDD). However, some MDD patients do not remit despite receiving an adequate dose and duration of SSRIs and TCAs.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, tolerability, and acceptability of bupropion for major depressive disorder: a meta-analysis of randomized–controlled trials comparison with venlafaxine

Maneeton¹,

Maneeton²,

Eurviriyanukul³

et al. 2013

DDDT

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BackgroundBupropion and venlafaxine are effective antidepressants with unique pharmacological profiles.ObjectivesThe purpose of this meta-analysis was to determine the efficacy, acceptability, and tolerability of bupropion and venlafaxine therapies for adults with major depressive disorder (MDD). The authors searched clinical trials with low risk of bias, performed from January 1985 to February 2013.Data sourcesThe searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Controlled Trials Register were conducted in February 2013. Included populations consisted of adult patients with MDD or major depression.Study eligible criteria, participants, and interventionsIncluded studies were randomized controlled trials (RCTs) comparing bupropion and venlafaxine in adult patients with MDD and offering endpoint results relevant to: (1) severity of depression; (2) response rate; (3) remission rate; (4) overall discontinuation rate; or (5) discontinuation rate due to adverse events. Limitation of language was not utilized.Study appraisal and synthesis methodsThe abstracts located from the electronic databases were reviewed. The completed reports from pertinent studies were examined, and essential data were extracted. Based on the Cochrane’s bias assessment, risks of bias were assessed. Any study with two risks or more was excluded. Efficacious outcomes included the mean changed scores of rating scales for depression, overall response rates, and overall remission rates. Acceptability was determined by the overall discontinuation rates. The discontinuation rates due to adverse events were the measurement of tolerability. Relative risks (RR) and weighted mean differences or standardized mean differences with 95% confidence intervals (CI) were computed using a random effect model.ResultsA total of 1,117 participants in three RCTs were included. Depression rating scales used in one and two studies were the 17-item Hamilton Depression Rating Scale and the Montgomery–Asberg Depression Rating Scale, respectively. The pooled mean changed scores of the bupropion-treated group were comparable to those of the venlafaxine-treated group with standardized mean differences (95% CI) of 0.05 (−0.16 to 0.26). The overall response and remission rates were similar with the RRs (95% CI) of 0.92 (0.79–1.08) and 0.97 (0.75–1.24), respectively. The pooled overall discontinuation rate and discontinuation rate due to adverse events were not different between groups with the RRs (95% CI) of 1.00 (0.80–1.26) and 0.69 (0.44–1.10), respectively.LimitationsThe small number of RCTs included in the meta-analysis.ConclusionAccording to the limited data obtained from three RCTs, bupropion XL is as effective and tolerable as venlafaxine XR for adult patients with MDD. Further studies in this area should be conducted to confirm these findings.

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“…The recommended dosages of TCAs have been proposed empirically, and a recent Cochrane review reported that lower doses of TCAs (75–100 mg/day or less) are equally effective as standard doses but have fewer side effects 10. When a TCA is prescribed as a co-analgesic, the dose is usually lower (50–75 mg).…”

Section: Tricyclic Antidepressants (Eg Amitriptyline Nortriptylinementioning

confidence: 99%

A brief review on the use of antidepressants in palliative care: Table 1

2012

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Low dosage tricyclic antidepressants for depression

Abstract: Cochrane Database of Systematic Reviews Analysis 9.5. Comparison 9 Low dosage TCA vs Standard dosage TCA, Outcome 5 Side e ects 1. Drop-outs due to side e ects..... 93 Analysis 9.6. Comparison 9 Low dosage TCA vs Standard dosage TCA, Outcome 6 Side e ects 2.

Cited by 48 publications

References 68 publications

The Management of Anxiety and Depressive Disorders: A Review

The Management of Anxiety and Depressive Disorders: A Review

Efficacy, tolerability, and acceptability of bupropion for major depressive disorder: a meta-analysis of randomized–controlled trials comparison with venlafaxine

A brief review on the use of antidepressants in palliative care: Table 1

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Low dosage tricyclic antidepressants for depression

Abstract: Cochrane Database of Systematic Reviews Analysis 9.5. Comparison 9 Low dosage TCA vs Standard dosage TCA, Outcome 5 Side e ects 1. Drop-outs due to side e ects..... 93 Analysis 9.6. Comparison 9 Low dosage TCA vs Standard dosage TCA, Outcome 6 Side e ects 2.

Cited by 48 publications

References 68 publications

The Management of Anxiety and Depressive Disorders: A Review

The Management of Anxiety and Depressive Disorders: A Review

Efficacy, tolerability, and acceptability of bupropion for major depressive disorder: a meta-analysis of randomized&ndash;controlled trials comparison with venlafaxine

A brief review on the use of antidepressants in palliative care: Table 1

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Efficacy, tolerability, and acceptability of bupropion for major depressive disorder: a meta-analysis of randomized–controlled trials comparison with venlafaxine