[Low dosages of tricyclic antidepressants].

Abstract

In a meta-analysis of 39 controlled studies, tricyclic antidepressants (TCAs) were found to be effective in the treatment of depressive disorders at dosages under 100 mg/day. No advantage was found for the generally recommended higher dosages. However, the authors ofthe analysis did not pay attention to the problems of diagnostic and therapeutic heterogeneity in the studies that were included. After a closer look, it seems plausible that TCAs do have an effect at lower dosages. Due to the diagnostic heterogeneity, however, it remains unclear whether the effect is on the core symptoms of depressive disorders or rather on symptoms such as anxiety, pain or sleep disorders. Due to the therapeutic heterogeneity, no claims with regard to the effectiveness of lower dosages are justified. The meta-analysis provides no reason to adjust the current guidelines for the dosage of TCAs in the treatment of depressive disorders.

• Authors: A M van Hemert, T K Birkenhäger
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 149 Issue 13 Pg. 677-9 (Mar 26 2005) ISSN: 0028-2162 [Print] Netherlands
• Vernacular Title: Lage dosering van tricyclische antidepressiva.
• PMID: 15819130 (Publication Type: Comment, English Abstract, Journal Article)

Chemical References

• Antidepressive Agents, Tricyclic

Topics

• Antidepressive Agents, Tricyclic (administration & dosage, therapeutic use)
• Depressive Disorder (drug therapy)
• Dose-Response Relationship, Drug
• Humans
• Meta-Analysis as Topic
• Treatment Outcome