Amoxapine versus amitriptyline in endogenous depression. A double-blind study.

Area of Science:

• Psychiatry
• Clinical Pharmacology

Background:

• Amoxapine is a novel dibenzoxazepine derivative antidepressant.
• Established antidepressants like amitriptyline are widely used but can have significant side effects.

Purpose of the Study:

• To compare the efficacy and safety of amoxapine with amitriptyline in patients with depression.
• To evaluate patient satisfaction and side effect profiles of both antidepressants.

Main Methods:

• A randomized, double-blind trial involving 48 patients diagnosed with depression.
• Treatment duration was 4 weeks, with most patients receiving 150 mg daily.
• Efficacy and side effects were assessed using multiple scales: Hamilton Psychiatric Rating Scale for Depression (HAM-D), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), Clinical Global Impression (CGI), and Patient's Self-Evaluation.

Main Results:

• Both amoxapine and amitriptyline significantly reduced depression scores (HAM-D).
• Amitriptyline showed greater efficacy for sleep disturbances and somatization symptoms.
• Amoxapine demonstrated better outcomes for anxiety/depression and apathy symptoms, with higher patient satisfaction in unipolar cases.
• Amoxapine exhibited a lower frequency and shorter duration of side effects, such as tremor and dizziness, compared to amitriptyline.

Conclusions:

• Amoxapine is an effective antidepressant with a favorable side effect profile.
• Amoxapine offers a viable alternative to amitriptyline, particularly for patients experiencing specific depressive symptoms and seeking reduced side effects.