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Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind, controlled trial

Published online by Cambridge University Press:  09 July 2009

Synopsis

A detailed analysis of the results of a multi-centre clinical trial shows that, while the relapse rate following recovery from an operationally defined depressive illness was smaller among patients subsequently treated with either amitryptiline or lithium than with a placebo, there was no clinically significant difference between the prophylactic efficacy of the 2 antidepressants. An account is given of the relative adverse effects of the treatments, and the implications of the findings are discussed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1984

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References

American Psychiatric Association (1975). Task Force on lithium therapy: the current status of lithium therapy. Report of the APA Task Force. American Journal of Psychiatry 133, 9971001.Google Scholar
Blackwell, B. & Shepherd, M. (1968). Prophylactic lithium: another therapeutic myth? Lancet i, 968971.CrossRefGoogle Scholar
Burch, J. E., Raddats, M. A. & Thompson, S. G. (1979). Reliable routine method for the determination of plasma amitriptyline and nortriptyline by gas chromatography. Journal of Chromatography 162, 351366.CrossRefGoogle ScholarPubMed
Coppen, A. & Abou-Saleh, M. T. (1983). Lithium in the prophylaxis of unipolar depression: a review. Journal of the Royal Society of Medicine 76 (4), 297301.CrossRefGoogle ScholarPubMed
Fleiss, J. L., Prien, R. F., Dunner, D. L. & Fieve, R. R. (1978). Actuarial studies of the course of manic-depressive illness. Comprehensive Psychiatry 19, 355362.CrossRefGoogle ScholarPubMed
Freedman, L. S. (1982). Tables of the number of patients required in clinical trials using the logrank test. Statistics in Medicine 1,121129.CrossRefGoogle ScholarPubMed
Glen, A. I. M., Dodd, M., Holme, E. B. & Kreitman, N. (1979). Mortality on lithium. Neuropsychobiology 5, 167173.CrossRefGoogle ScholarPubMed
Gross, A. J. & Clark, V. A. (1975). Survival Distributions: Reliability Applications in the Biomedicai Sciences. John Wiley & Sons: London.Google Scholar
Medical Research Council (1965). Clinical trial of the treatment of depressive illness. British Medical Journal i, 881886.Google Scholar
Medical Research Council Drug Trials Subcommittee (1981). Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a controlled clinical trial. Psychological Medicine 11, 409416.CrossRefGoogle Scholar
Mindham, R. H. S., Howland, C. & Shepherd, M. (1973). An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine 3, 517.CrossRefGoogle ScholarPubMed
Pert, A. & Bunney, W. E. Jr (1981). Chronic lithium modulates neurotransmitter receptor sensitivity. In Basic Mechanisms in the Action of Lithium (ed. Emrich, H. M. Alderhoff, J. B. and Lux, H. D.), pp. 121132. Excerpta Medica: Amsterdam.Google Scholar
Peto, R. Pike, M. C., Armitage, P., Breslow, N. E., Cox, D. R., Howard, S. N., Mantel, N., McPherson, K., Peto, J. & Smith, P. C. (1973). Design and analysis of randomized clinical trials requiring prolonged observations of each patient. II. Analysis and examples. British Journal of Cancer 35, 139.CrossRefGoogle Scholar
Prien, R. (1983 a). Lithium and the long-term maintenance treatment of recurrent depression: a continuing controversy. In Treatment of Depression: Old Controversies and New Approaches (ed. Clayton, P. J. and Barrett, J. E.), pp. 105113 Raven Press: New York.Google Scholar
Prien, R. (1983 b). Report on New Clinical Drug Evaluation Unit Program. Annual meeting of the Division of Extramural Research Programs, National Institute of Mental Health (unpublished).Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders. Biometrics Research: New York State Psychiatric Institute.Google Scholar