The authors report four cases of Monopolar Depressed patients who developed manic features for the first time while on tricyclic antidepressant therapy. The phenomenon is viewed as tricyclic antidepressant induced mania. The manic symptoms occurred late in therapy, with moderate doses of tricyclic antidepressants (125-150 mg per day) and were easily controlled with antipsychotic medication. Fac...

Background—Depression worsens the prognosis in patients with cardiac disease, and treatment with antidepressants may improve survival. Guidelines recommend use of selective serotonin reuptake inhibitors (SSRIs), but knowledge of the prognostic effect of different classes of antidepressants is sparse. Methods and Results—We studied 99 335 patients surviving first hospitalization for heart failur...

BACKGROUND Migraine, ranked as the 7th-highest specific cause of disability worldwide, has caused an enormous burden on the economy and society. Tricyclic antidepressant (TCA) is one of the most commonly drugs for migraine prevention. However, evidence about the efficacy and tolerability of TCAs in the prophylaxis of migraine in adults is somewhat confusing. METHODS A computerized literature ...

We conducted a cost-effectiveness analysis of acute major depressive disorder (MDD) using serotonin-norepinephrine reuptake inhibitors (SNRIs; venlafaxine), selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, sertraline, paroxetine), or tricyclic antidepressants (TCAs; amitriptyline, imipramine, desipramine, nortriptyline). A decision-tree model over 6 months was constructe...

I read the review article by Wijkstra et al (2006) with much interest as I found the results in the abstract quite striking. However, I wish to raise a few points about the methodology and description of results. First, the authors have concluded from two studies by Bruijn et al (1996) and van den Broek et al (2004) that tricyclic antidepressants (TCAs) are more efficacious than non-TCAs in tre...

OBJECTIVES The aim of this study was to establish the relative safety and balance of risks for antidepressant treatment in older people. The study objectives were to (1) determine relative and absolute risks of predefined adverse events in older people with depression, comparing classes of antidepressant drugs [tricyclic and related antidepressants (TCAs), selective serotonin reuptake inhibitor...

Tricyclic antidepressants have not been explicitly studied in the conservative treatment of lumbar spinal stenosis. A retrospective chart review was conducted in a subset of patients with chronic low back pain and lumbar spinal stenosis managed with low dose tricyclic antidepressants. Of 26 patients, 20 reported improvement in back pain. The majority of patients reported improvement with an ini...

Myocardial Infarction To the Editor: In a recent study, Sauer et al1 showed that the use of selective serotonin reuptake inhibitor antidepressants (SSRIs) may confer a protective effect against myocardial infarction (MI) in smokers. They hypothesized that this beneficial effect of SSRIs in reducing the risk of MI could mainly be attributed to the inhibitory effect on serotonin-mediated platelet...

Posternak and Zimmerman reported on a series of 74 outpatients with depressive disorders who were treated in their group practice at the Rhode Island Hospital between 1996 and 1999. All of the patients had either failed to respond to or relapsed after responding to an adequate trial of antidepressant medication. The treating psychiatrists either switched the patients to another antidepressant (...

OBJECTIVE Although depression has been shown to be a long-term disorder, most research studies have concentrated on its acute treatment. METHOD A literature review of the use of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) in long-term treatment of depression was performed and recommendations regarding long-term treatment were summarized. RESULTS Stud...