Amitriptyline and the "cheese" reaction to MAOIs.
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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.
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This study compared serial severity ratings from 2 methodologically similar tricyclic antidepressant studies. Though the groups resembled each other in terms of diagnosis and baseline severity, response patterns were surprisingly different. In particular, early change was highly predictive of outcome in one group but not in the other. The results of response predictor studies must, therefore, be generalized with caution. These data, nevertheless, do allow some guidelines for predicting response from early changes and severity.
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