The efficacy and safety of cyclic antidepressants

Abstract

Cyclic antidepressants are widely used as the first line antidepressants in developing country. Ninety six depressed out-patients with minimum baseline Hamilton Depressive Rating Scale (HDS) score 0f 11 entered an open clinical trial. The maximum daily dose allowed was equivalent to 150 mg of imipramine. The highest effective dose was continued for 6 weeks. Most (96%) of the patients tolerated cyclic antidepressants and only 4 required new generation of antidepressants. Eighty six (94%) patients responded to the treatment regime while the other 6 required higher doses of antidepressants. About 69% of the patients improved with the equivalent daily dose of 75 to 100 mg of imipramine. It is concluded that majority of the depressed out-patients tolerated and required a moderate dose of tricyclic antidepressants. It seems that the routine first line treatment with newer antidepressants at current price is not cost-effective.