The treatment of depression in patients with epilepsy. A double-blind trial

Forty-two patients with depression and epilepsy were entered into an antidepressant trial of amitriptyline, nomifensine and placebo. The dose of the active drug was 25 mg tid, which was doubled in non-responders on the active drug after 6 weeks. At that point a further 6 week follow-up was carried out. Serum antidepressant and anticonvulsant levels were assessed. The results indicated that at 6 weeks all patients showed a decline in their depression scores but at 12 weeks nomifensine was superior to amitriptyline. The possible reasons for this and the clinical implications of this are discussed.