COMPARATIVE EFFICACY OF LITHIUM AND AMITRIPTYLINE IN THE MAINTENANCE TREATMENT OF RECURRENT UNIPOLAR DEPRESSION - A RANDOMIZED STUDY

The present study, including 81 depressive patients, compares the prop hylactic efficacy of lithium and amitriptyline in recurrent unipolar d epression over a treatment period of 2.5 years in a randomised multice ntre design. Hospitalisation, re-emergence of depressive or subdepress ive recurrences, unwanted side-effects and need of concomitant psychot ropic medication were considered to indicate treatment failures. Avera ge dosage for amitriptyline was 98 +/- 37 mg/day, average lithium bloo d level was 0.59 +/- 0.12 mmol/l. Survival analyses demonstrated a sig nificant superiority of lithium (P = 0.015) regarding the outcome crit eria 'recurrences and/or subclinical recurrences' and non-significantl y better results of lithium compared to amitriptyline concerning 'recu rrence' (P = 0.059) or 'recurrence and/or concomitant medication' (P = 0.066).