The Pharmaceutical Journal
Vol 269 No 7223 p668
9 November 2002

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BMJ (bmj.com)

Use of low-dose tricyclics justified

The use of tricyclic antidepressants at lower-than-recommended doses is justified, say the authors of a systematic review.

They reviewed data from 35 studies comparing low-dose tricyclics with placebo and from six studies comparing low-dose with standard-dose tricyclics. They point out that evidence for the recommended dose of tricyclic antidepressants, which many guidelines say is 100mg to 125mg daily, is poor. Furthermore, they add that there is a lack of convincing evidence that lower doses are not effective.

They found that low-dose tricyclics were more likely than placebo to bring about an improvement in the symptoms of depression. Data also failed to show that standard doses of tricyclics were any more likely to bring about a response. However, a higher proportion of patients treated with standard doses dropped out of trials because of side effects (BMJ 2002;325:991).