The Efficacy of Antidepressant Drugs

Morris, Jeffery B.

doi:10.1001/archpsyc.1974.01760110083010

Cited by 338 publications

(38 citation statements)

References 109 publications

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“…Reviews and meta-analyses of randomized, double-blind, placebo-controlled, antidepressant studies [7, 8, 9, 10, 11]have provided evidence that antidepressants are more effective than placebo. One of the original comprehensive literature reviews by Morris and Beck [9]found that tricyclic antidepressants were superior to a placebo in 63 out of 91 (69%) controlled studies published between 1958 and 1972.…”

Section: Belief No 1: Antidepressants Are Conclusively More Effectivmentioning

confidence: 99%

“…One of the original comprehensive literature reviews by Morris and Beck [9]found that tricyclic antidepressants were superior to a placebo in 63 out of 91 (69%) controlled studies published between 1958 and 1972. Though this review, and the others that followed, generally supported the efficacy of antidepressants, some problems with the publication process and the research paradigm may diminish the strength of this support.…”

Section: Belief No 1: Antidepressants Are Conclusively More Effectivmentioning

confidence: 99%

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Raising Questions about Antidepressants

Antonuccio

Danton

DeNelsky

et al. 1999

Psychother Psychosom

104

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Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the ‘true’ antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.

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Section: Belief No 1: Antidepressants Are Conclusively More Effectivmentioning

confidence: 99%

Section: Belief No 1: Antidepressants Are Conclusively More Effectivmentioning

confidence: 99%

Raising Questions about Antidepressants

Antonuccio

Danton

DeNelsky

et al. 1999

Psychother Psychosom

104

View full text Add to dashboard Cite

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“…Their therapeutic efficacy has been established in double-blind, placebo-controlled clinical trials over many years (Morris & Beck, 1974). These compounds and their newer analogues are the main therapeutic agents for the treatment of endogenous depression (Montgomery, 1994).…”

Section: Discussionmentioning

confidence: 99%

“…However, objections to this hypothesis have been raised (Anonymous, 1982;Carlsson, 1984;Leonard, 1993). The known pharmacological actions of the antidepressants are believed to explain the various clinical untoward effects of these compounds, but they do not correlate with their therapeutic efficacy (Morris & Beck, 1974;Baldessarini, 1990). Endogenous depression is characterized by derangements of hypothalamic function, including disturbances of pituitary hormone secretion, sleep pattern, appetite and reproductive function.…”

Section: Discussionmentioning

confidence: 99%

Binding and competitive inhibition of amine uptake at postsynaptic neurones (transport‐P) by tricyclic antidepressants

Al-Damluji

Kopin

1996

British J Pharmacology

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1 We have provided evidence for a novel amine uptake process for which prazosin is a substrate in postsynaptic neurones, characterized by a paradoxical increase in accumulation of the radioligand when the concentration of the unlabelled drug is increased above 10' M. This increase is due to activation of a proton-dependent, vacuolar type-ATPase-linked uptake process which is blocked by desipramine but is resistant to reserpine. We have now examined the effects of tricyclic antidepressants on this uptake system in a cell line derived from hypothalamic peptidergic neurones, known to be innervated by noradrenergic nerve terminals in vivo.2 [3H]-imipramine bound to the cells and was displaced by unlabelled imipramine, desipramine, amitriptyline and nortriptyline. The data fitted a single binding site model. This is the first demonstration of antidepressant binding sites in postsynaptic neurones. 3 There was no increase in the binding of [3H]-imipramine at high concentrations of unlabelled imipramine, suggesting that antidepressants inhibit uptake but are not themselves accumulated by peptidergic gonadotrophin releasing hormone neurones. 4 Accumulation of prazosin was competitively inhibited by antidepressants. Tertiary amines were slightly more potent than secondary amines and the presence of a nitrogen atom in the heterocyclic ring enhanced blocking activity. 5 The affinities of the antidepressants for the uptake process are within the range of plasma concentrations that are observed during therapeutic use of these compounds. Since it is likely that this uptake process has a physiological function, its inhibition by antidepressants may provide a new avenue for investigating the mechanism of action of these compounds.

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“…This class of drugs represents a powerful therapeutic agent. Morris and Beck (1974) reviewed 93 doubleblind studies involving tricyclics, and in 61 studies, the tricyclic was significantly more effective than a placebo. In no study was a placebo more effective than a tricyclic.…”

mentioning

confidence: 99%