Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T08:42:30.290Z Has data issue: false hasContentIssue false
  • English
  • Français

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

Published online by Cambridge University Press:  02 January 2018

Sinead O'brien ,
Patrick McKeon  and
Myra O'regan
Sinead O'brien*
Affiliation:
Student Health Centre, Trinity College, Dublin 2, Ireland
Patrick McKeon
Affiliation:
Depression Research Unit, St Patrick's Hospital, Dublin 8, Ireland
Myra O'regan
Affiliation:
Statistics and Operations Research Laboratory, Trinity College, Dublin 2, Ireland
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 3 , March 1993 , pp. 363 - 368
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

Ananth, J. & Luchins, D. (1977) A review of combined tricyclic and MAOI therapy. Comprehensive Psychiatry, 18, 221—230.CrossRefGoogle ScholarPubMed
Ayd, F. (1979) Guidelines for safe and effective use of combined tricyclic-MAOI therapy. International Drug Therapy Newsletter, 14, 7—8.Google Scholar
Beck, A. T. & Beamesderfer, A. (1974) Assessment of depression: the depression inventory. In Psychological Measurements in Psychopharmacology, Modem Problems in Pharmacopsychiatry, Vol. 7 (ed. Pichot, P.). Basel, Switzerland: Karger.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659—674.CrossRefGoogle Scholar
Carroll, B. J., Fielding, J. M. & Blashki, T. G. (1973) Depression rating scales: a critical review. Archives of General Psychiatry, 28, 361—366.Google Scholar
Cleary, P. & Guy, W. (1977) Factor analysis of the Hamilton Depression Scale. Drugs Under Experimental and Clinical Research, 1, 115—120.Google Scholar
Davidson, J., McLeod, M., Law-Yone, B., et al (1978) A comparison of electroconvulsive therapy and combined phenelzine-amitriptyline in refractory depression. Archives of General Psychiatry, 35, 639—642.Google Scholar
Davidson, J., McLeod, M., & Blum, M. R. (1978) Acetylation phenotype, platelet monoamine oxidase inhibitor and the effectiveness of phenelzine in depression. American Journal of Psychiatry, 135, 467—469.Google ScholarPubMed
Hamilton, M. (1960) A rating scale for depression. Journal of Neurological and Neurosurgical Psychiatry, 23, 56—62.CrossRefGoogle ScholarPubMed
Harris, B., Young, J. & Hughes, B. (1986) Comparative effects of seven antidepressant regimes on appetite, weight and carbohydrate preference. British Journal of Psychiatry, 148, 590—592.CrossRefGoogle ScholarPubMed
Mowbray, R. M. (1972) The Hamilton Rating Scale for Depression: a factor analysis. Psychological Medicine, 2, 272—280.Google Scholar
O'Brien, S., McKeon, P. & O'Regan, M. (1991) A comparative study of the electrocardiographic effects of tranylcypromine and amitriptyline when prescribed singly and in combination. International Clinical Psychopharmacology, 6, 11—16.Google Scholar
Ponto, L. (1977) Tricyclic antidepressant and monoamine oxidase inhibitor combination therapy. Drug Therapy Reviews, 34, 954—961.Google Scholar
Quitkin, F., Rabkin, J., Ross, D., et al (1984) Duration of antidepressant drug treatment. Archives of General Psychiatry, 41, 238—245.Google Scholar
Razani, J., White, J., Simpson, G., et al (1983) The safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatment. Archives of General Psychiatry, 40, 657—661.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L. et al. (1973) The monoamine oxidase inhibitor, phenelzine, in the treatment of depressive-anxiety states. A controlled clinical trial. Archives of General Psychiatry, 29, 407—413.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L., et al (1978) Clinical psychopharmacology of phenelzine: MAO activity and clinical response. In Psychopharmacology: A Generation of Progress (eds Lipton, M. A., Dimascio, A. & Killam, K. F.), pp. 961—973. New York: Raven Press.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773—782.Google Scholar
White, K. & Simpson, G. (1981) Combined MAOI-tricyclic antidepressant treatment: a re-evaluation. Journal of Clinical Psychopharmacology, 1, 264—282.CrossRefGoogle Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (1CD-9). Geneva: WHO.Google Scholar
Young, J. P. R., Lader, M. H. & Hughes, W. C. (1979) Controlled trial of trimipramine, monoamine oxidase inhibitors, and combined treatment in depressed outpatients. British Medical Journal, iv, 1315–1317.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.