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Published on: January 7, 2019
Low dosage tricyclic antidepressants for depression.
T Furukawa1, H McGuire, C Barbui
1Dept of Psychiatry, Nagoya City University Medical School, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.
Low dose tricyclic antidepressants (TCAs) are effective for treating depression, showing better response rates than placebo. Standard doses did not improve response but increased side effects compared to low doses.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Tricyclic antidepressants (TCAs) remain widely prescribed globally.
- Evidence supporting optimal TCA dosage for depression treatment is limited.
Purpose of the Study:
- To compare low-dose TCAs against placebo and standard-dose TCAs for acute depression treatment.
- To evaluate efficacy and side effect profiles of different TCA dosages.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched multiple databases (MEDLINE, EMBASE, PsycLIT, etc.) and hand-searched journals.
- Included trials comparing low-dose TCA (<=100 mg/day) with placebo or standard-dose TCAs in adults with depression.
Main Results:
- Low-dose TCAs (75-100 mg/day) were significantly more effective than placebo at 4 weeks (RR 1.65) and 6-8 weeks (RR 1.47).
- Standard-dose TCAs did not show superior response rates compared to low-dose TCAs.
- Standard-dose TCAs resulted in more dropouts due to side effects than low-dose TCAs.
Conclusions:
- Low-dose TCA treatment for adult depression is clinically justified.
- Further high-quality research is necessary to fully elucidate the benefits and risks of varying TCA dosages.
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