A controlled comparison of trimipramine and amitriptyline

Depressed patients seen in a private psychiatric practice (N = 41) were randomly assigned to receive trimipramine or amitriptyline over a study period of at least 4 weeks. Patients in both groups showed significant improvement over time on measures of mood and depression, and on psychological scales. Only one variable, the global improvement rating, showed a significant overall between-groups difference, which favored amitriptyline treatment. This difference may reflect the presence of significantly less baseline symptomatology in the amitriptyline group. Trimipramine patients were more seriously ill on initial diagnosis and showed significantly more improvement at week 2 than amitriptyline patients and a trend toward fewer side effects. Thus, trimipramine may be useful for patients particularly sensitive to side effects in whom evidence of early response is important.