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Related Experiment Videos

Nortriptyline for treatment-resistant depression.

Andrew A Nierenberg1, George I Papakostas, Timothy Petersen

  • 1Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, USA. anierenberg@partners.org

The Journal of Clinical Psychiatry
|February 20, 2003
PubMed
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Nortriptyline effectively treated over a third of patients with treatment-resistant depression. This tricyclic antidepressant offers a viable option when initial treatments like SSRIs fail.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Medicine

Background:

  • Major depression affects many, with up to 30% not responding to initial antidepressant trials, often selective serotonin reuptake inhibitors (SSRIs).
  • Tricyclic antidepressants (TCAs) show potential for SSRI nonresponders but are typically used later in treatment.
  • This study investigates nortriptyline's efficacy in treatment-resistant major depression.

Purpose of the Study:

  • To evaluate the effectiveness of nortriptyline in patients with major depression resistant to other antidepressant treatments.
  • To assess nortriptyline as a potential alternative for patients who have not responded to previous therapies.

Main Methods:

  • 92 patients with treatment-resistant major depression received open-label nortriptyline for 6 weeks.

Related Experiment Videos

  • Dosage was rapidly titrated, aiming for blood levels of 100 ng/mL.
  • Response was defined as a ≥50% reduction in the Hamilton Rating Scale for Depression score; intent-to-treat analysis was used.

    • Main Results:

    • Approximately 40% of patients (N=39) responded to nortriptyline treatment.
    • 12% of patients (N=11) achieved remission after 6 weeks.
    • Over one-third of participants did not complete the full 6-week trial.

    Conclusions:

    • Nortriptyline demonstrated efficacy in over a third of patients with treatment-resistant depression.
    • Nortriptyline should be considered a potential treatment option for patients who fail to respond to other antidepressants.
    • Further research may explore factors influencing completion rates and long-term outcomes.