Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T15:22:17.769Z Has data issue: false hasContentIssue false

Continuation Therapy with Amitriptyline in Depression

Published online by Cambridge University Press:  29 January 2018

A. Coppen*
Affiliation:
Preston Hall Hospital, British Legion Village, Maidstone, Kent
K. Ghose
Affiliation:
Preston Hall Hospital, British Legion Village, Maidstone, Kent
S. Montgomery
Affiliation:
Preston Hall Hospital, British Legion Village, Maidstone, Kent
V. A. Rama Rao
Affiliation:
Medical Research Council Neuropsychiatry Laboratory
J. Bailey
Affiliation:
West Park Hospital, Epsom, Surrey, U.K.
A. Jorgensen
Affiliation:
H. Lundbeck & Co., A/S, Ottiliavej 7–9, DK-2500 Valby, Copenhagen, Denmark
*
Requests for reprints should be addressed to Dr A. Coppen

Summary

Thirty-two patients who had responded to amitriptyline (150 mg daily) when suffering from a depressive illness were allocated either to receive placebo or to remain on the same medication for one year.

Plasma concentrations of the drug were regularly estimated. There was no correlation between plasma concentration and subsequent residual affective morbidity. In spite of considerable encouragement, three of the patients did not take the prescribed amitriptyline and they all relapsed. Five out of sixteen patients who received placebo relapsed. None of the patients who continued to take amitriptyline relapsed.

It is emphasized that the patients studied were selected, inasmuch as they were apparent responders to amitriptyline. It is concluded that this group of patients should continue to be treated with antidepressant medication for eight months after apparent recovery, and care should be taken to ensure the patients' compliance.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baastrup, P. C., Poulsen, J. C., Schou, M., Thomsen, K. & Amdisen, A. (1970) Prophylactic lithium: double-blind discontinuation in manic-depressive and recurrent depressive disorders. Lancet, ii, 326–30.Google Scholar
Blackwell, B. (1976) Treatment adherence. British Journal of Psychiatry, 129, 513–31.Google Scholar
Braithwaite, R. A., Goulding, R., Theano, G., Bailey, J. & Coppen, A. (1972) Plasma concentration of amitriptyline and clinical response. Lancet, i, 12971300.Google Scholar
Burrows, G. D., Vohsa, J., Hunt, D., Slowan, J. G., Scoggins, B. A. & Davies, B. Cardiac effects of different tricyclic antidepressant drugs. British Journal of Psychiatry, 129, 335–41.Google Scholar
Coppen, A., Noguera, R., Bailey, J., Burns, B. H., Swani, M. S., Hare, G. H., Gardner, R. & Maggs, R. (1971) Prophylactic lithium in affective disorders. Lancet, ii, 275–9.Google Scholar
Coppen, A., Gupta, R., Montgomery, S. & Bailey, J. (1976) A double-blind comparison of lithium carbonate and ludiomil in the prophylaxis of unipolar affective illness. Pharmacopsychiatry, 9, 94–9.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.Google Scholar
Imlah, N. W., Ryan, E. & Harrington, J. A. (1965) The influence of antidepressant drugs on the response to electroconvulsive therapy and on subsequent relapse rate. In: Neurosychopharmacology (eds Benle, P. and Bradley, P.). Vol. 4, pp 438–42. Amsterdam, London, New York: Elsevier.Google Scholar
Jorgensen, A. (1975) A gas chromatographic method for determination of amitriptyline and nortriptyline in human serum. Acta Pharmacologica et Toxicologica, 36, 7990.Google Scholar
Kay, D. W. K., Fahy, T. & Garside, R. F. (1970) A seven month double-blind trial of amitriptyline and diazepam in ECT treated depressed patients. British Journal of Psychiatry, 117, 667–7.CrossRefGoogle ScholarPubMed
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. Report to the Medical Research Council by its clinical psychiatry committee. British Medical Journal, i, 881–6.Google Scholar
Mindham, R. H. S., Howland, C. & Shephard, M. (1973) An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine, 3, 517.Google Scholar
Paykel, E. S., Di Mascio, A., Klerman, G. L., Prusoff, B. A. & Weismann, M. M. (1976) Maintenance therapy of depression. Pharmacopsychiatry, 9, 127–36.Google Scholar
Prien, R. F., Caffey, E. M. & Klett, J. (1973) Prophylactic efficacy of lithium carbonate in manic-depressive illness. Archives of General Psychiatry, 28, 337–41.Google Scholar
Seager, C. P. & Bird, R. L. (1962) Imipramine with electrical treatment in depression—a controlled trial. Journal of Mental Science, 108, 704–7.Google Scholar
Sokal, R. R. & Rohlf, F. J. (1969) ‘G’ Test. In: Biometry, W. H. Freeman, San Francisco.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.