RANDOMIZED, CONTROLLED TRIAL OF AMITRIPTYLINE IN THE ACUTE TREATMENT OF ADOLESCENT MAJOR DEPRESSION

Objective: To determine amitriptyline's (AMI) efficacy in the acute tr eatment of adolescent major depressive disorder (MDD). Method: Subject s aged 12 through 17 years meeting Research Diagnostic Criteria for MD D, diagnosed with the Schedule for Affective Disorders and Schizophren ia for School-Age Children (K-SADS), participated in a 2-week placebo- washout followed by an 8-week, randomized, double-blind, parallel-desi gn, placebo-controlled trial of AMI, 5 mg/kg per day. The K-SADS nine- item scale, the Hamilton Depression Rating Scale, and the Clinical Glo bal Impressions rating scale were used as outcome measures. Results: T hirty-one subjects were randomized (18 AMI, 13 placebo). Twenty-two su bjects were study completers (12 AMI, 10 placebo). AMI's efficacy was suggested by the Clinical Global Impressions but not the K-SADS-derive d data. Perhaps the primary limitation of the current study is its sma ll sample size. Conclusion: No definitive recommendation can be made r egarding the efficacy of tricyclic antidepressants in the treatment of adolescent MDD.