INITIAL LITHIUM AUGMENTATION IMPROVES THE ANTIDEPRESSANT EFFECTS OF STANDARD TCA TREATMENT IN NON-RESISTANT DEPRESSED-PATIENTS

The hypothesis was tested that an initial lithium-tricyclic antidepres sant (TCA) combination has a better antidepressant effect than standar d TCA treatment in non-refractory depression at the beginning of an ep isode. Twenty bipolar melancholic type depressed inpatients under lith ium-TCA treatment were compared with 20 patients with the same diagnos is and TCA-placebo treatment for 5 weeks under double-blind conditions . All patients were male. Initial lithium-TCA treatment reduced depres sive symptoms significantly more than antidepressant treatment with TC A and placebo after 5 weeks, but not in weeks 1 or 2. It can be conclu ded that lithium augmentation of TCA treatment should be started even at the beginning of antidepressant TCA treatment to provide a better t reatment response in those patients who will profit from long-term lit hium prophylaxis, e.g. bipolar patients with melancholic type depressi on.