According to the findings of this review, treatment of depression in adults with low dose tricyclics is acceptable. However, the authors note that more rigorous studies are required to definitively establish the relative benefits and harms of various dosages.
The authors carried out a systematic review of randomised trials that compared low dosage tricyclics (=100 mg/day) with placebo or with typical dosage tricyclics in adults with depression.
The main out come measures used were the relative risk of response in depression according to the original authors’ definition but usually defined as 50% or greater reduction in severity of depression and the relative risks of overall dropouts and dropouts due to side effects. In total 35 studies (involving 2013 participants) compared low dosage tricyclics with placebo, and six studies (involving 551 participants) compared low dosage tricyclics with standard dosage tricyclics. The results found:
– Low dosage tricyclics, mainly between 75 and 100 mg/day, were 1.65 (95% confidence interval 1.36 to 2.0) and 1.47 (1.12 to 1.94) times more likely than placebo to bring about response at 4 weeks and 6-8 weeks, respectively.
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