title: Paroxetine versus amitriptyline in patients with recurrent major depression: A double-blind trial.
abstract: BACKGROUND
  Long-term exposure to antidepressants is required to prevent relapses and recurrences in patients with recurrent major depression. Furthermore, a good pharmacological compliance is the key to successful long-term treatment. Since the early phases of a treatment influence long-term compliance and compliance is adversely affected by poorly tolerated treatments, efficacy and tolerability of paroxetine and amitryptiline over 12 weeks were compared as an introduction to the issue of long-term compliance to these two agents.
  
  
  METHODS
  A 12-week, randomized, double-blind, doubledummy, parallel-group trial which involved 129 patients with recurrent major depression.
  
  
  RESULTS
  Both paroxetine and amitriptyline were effective in controlling the symptoms of depression, as shown by the reduction in HAMD total score and CGI severity-of-illness score at endpoint compared to baseline. There was no statistically or clinically significant difference between the two treatments in terms of efficacy. However, marked numerical differences were noted in tolerability: the percentage of patients who reported treatment-emergent adverse experiences was greater in the amitriptyline group (40.0% vs 28.1%). This difference was mainly due to anticholinergic adverse events, which were six times more frequent with amitriptyline than with paroxetine.
  
  
  CONCLUSIONS
  When compared with amitriptyline, paroxetine should allow patients with recurrent major depression to receive an equally effective treatment with a relatively lower incidence of adverse experiences.
authors.forename: Emilio
authors.initials: E
authors.lastname: Sacchetti
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Cassano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Penati
authors.forename: Luigi
authors.initials: L
authors.lastname: Pavan
authors.forename: Marcello
authors.initials: M
authors.lastname: Nardini
authors.forename: Massimo
authors.initials: M
authors.lastname: Casacchia
authors.forename: Paolo
authors.initials: P
authors.lastname: Pancheri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Muscettola
authors.forename: Carlo
authors.initials: C
authors.lastname: Faravelli
authors.forename: Eugenio
authors.initials: E
authors.lastname: Aguglia
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Nivoli
authors.forename: Luigi
authors.initials: L
authors.lastname: Ravizza
authors.forename: Paolo
authors.initials: P
authors.lastname: Castrogiovanni
keywords: Amitriptyline; Clinical; Depression; Efficacy; Paroxetine; Trial