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Evidence summaries

Low Dosage Tricyclic Antidepressants for Depression

In the treatment of depression, tricyclic antidepressants in the range between 75-100 mg/day and possibly below this range are more effective than placebo. They appear to have similar efficacy as standard dosage tricyclics but result in fewer dropouts due to side effects. Level of evidence: "A"

A Cochrane review (abstract , review [Abstract]) included 41 studies with a total of 2564 patients. Low dosage tricyclics, mostly between 75 and 100 mg/day, were 1.65 (95% confidence interval 1.36 to 2.0) and 1.47 (1.12 to 1.94) times more likely than placebo to bring about response at 4 weeks and 6-8 weeks, respectively. Standard dosage tricyclics failed, however, to bring about more response but produced more dropouts due to side effects than low dosage tricyclics.

    References

    • Furukawa T, McGuire H, Barbui C. Low dosage tricyclic antidepressants for depression. Cochrane Database Syst Rev 2003;(3):CD003197. [PubMed]

Primary/Secondary Keywords