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Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind, controlled trial


A detailed analysis of the results of a multi-centre clinical trial shows that, while the relapse rate following recovery from an operationally defined depressive illness was smaller among patients subsequently treated with either amitryptiline or lithium than with a placebo, there was no clinically significant difference between the prophylactic efficacy of the 2 antidepressants. An account is given of the relative adverse effects of the treatments, and the implications of the findings are discussed.

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3 Address for correspondence: Professor Michael Shepherd Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
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J. E. Burch , M. A. Raddats & S. G. Thompson (1979). Reliable routine method for the determination of plasma amitriptyline and nortriptyline by gas chromatography. Journal of Chromatography 162, 351366.

J. L. Fleiss , R. F. Prien , D. L. Dunner & R. R. Fieve (1978). Actuarial studies of the course of manic-depressive illness. Comprehensive Psychiatry 19, 355362.

L. S. Freedman (1982). Tables of the number of patients required in clinical trials using the logrank test. Statistics in Medicine 1,121129.

A. I. M. Glen , M. Dodd , E. B. Holme & N. Kreitman (1979). Mortality on lithium. Neuropsychobiology 5, 167173.

R. Peto M. C. Pike , P. Armitage , N. E. Breslow , D. R. Cox , S. N. Howard , N. Mantel , K. McPherson , J. Peto & P. C. Smith (1973). Design and analysis of randomized clinical trials requiring prolonged observations of each patient. II. Analysis and examples. British Journal of Cancer 35, 139.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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