title: Therapy with amineptine, a dopamine reuptake inhibitor, in patients with major depression.
abstract: The original tricyclic antidepressant drugs are consistently underused in major depression because of side effects, delayed onset of action, and potential for overdose. In an open study of 6 weeks' duration, we studied the efficacy and acceptability of amineptine, a dopamine reuptake inhibitor, at fixed dose of 200 mg per day in 50 patients with major depression.Intention-to-treat analysis showed a patient response rate of 64% (95% CI 77-50) in HDRS, 62% (95% CI 75-48) in MADRS, 46% (95% CI 59-32) in ZUNG scale, 52% (95% CI 66-38) in Social Activity scale, and 26% ("95% CI 38-14) in CGI-severity of illness after 7 days treatment. Response in CGI-global improvement was 38% (95% CI 51-25), and in CGI-efficacy index 48% (95% CI 62-34) after 14 days of treatment. With continued therapy, only CGI-severity of illness showed a significant increase in response rate after 42 days. The treatment effect of amineptine was reflected in a significant and progressive improvement in all depression, social activity, and CGI rating scale scores throughout the study period. Somatic symptoms and side effects assessed by AMDP-5 showed significant improvement at each assessment.The clinically useful response in depression which occurred by the first week of treatment, favourable side effect profile, and the convenience of a fixed dose could make amineptine a suitable first line alternative for the treatment of major depression.
authors.affiliation: S.M. CHANNABASAVANNA, M.D., Professor of Psychiatry & Director, Department of Psychiatry, NIMHANS, Bangalore- 560029.
authors.forename: S M
authors.initials: SM
authors.lastname: Channabasavanna
authors.forename: S
authors.initials: S
authors.lastname: Khanna