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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 

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