Antidepressants: which one?
There are now 15 effective antidepressant medicines marketed in Canada (eight tricyclic antidepressants, three monoamine oxidase inhibitors, and four medicines with novel chemical structures). The tricyclics remain the drug of first choice for major depressions, because of their proven efficacy over three decades, their known side effect profiles, and the cheaper cost of imipramine and amitriptyline compared to other tricyclics and the new antidepressants. The monoamine oxidase inhibitors are an excellent alternative, and are far safer than earlier reports suggested. Maprotiline offers few advantages over the tricyclics and costs significantly more. Trazodone may be a second- or third-line drug with the advantage of minimal anticholinergic properties. Adequate clinical evaluation of nomifensine has not yet occurred. Neuroleptic and cardiotoxic properties of amoxapine suggest other medicines should be tried first.
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Remick
J Clin Psychiatry. 1983 Feb;44(2):63-5
6826533
J Clin Psychopharmacol. 1983 Oct;3(5):307-10
6630590
Am J Psychiatry. 1982 Sep;139(9):1193-4
7114318
Pharmacotherapy. 1981 Nov-Dec;1(3):163-78
6152816
Drugs. 1979 Jul;18(1):1-24
477572
Ann Intern Med. 1978 Jul;89(1):78-84
666196
JAMA. 1983 Aug 26;250(8):1069-71
6876345
Psychiatr Dev. 1983 Summer;1(2):123-60
6371797
JAMA. 1982 Oct 15;248(15):1848-55
6126602
Arch Gen Psychiatry. 1978 Jun;35(6):756-66
655773
Am J Psychiatry. 1978 Jan;135(1):69-74
201174
J Clin Psychopharmacol. 1983 Aug;3(4):249-52
6886038
Arch Gen Psychiatry. 1981 Jan;38(1):15-22
7458567
Am J Psychiatry. 1983 Aug;140(8):1006-9
6346907
Pharmacotherapy. 1982 Sep-Oct;2(5):255-65
6763207
Arch Gen Psychiatry. 1981 Jul;38(7):815-20
7247643