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  Vol. 281 No. 20, May 26, 1999 TABLE OF CONTENTS
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Dose of Tricyclic Antidepressants in Elderly Patients

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Reynolds and colleagues1 concluded that nortriptyline, a tricyclic antidepressant, was superior to placebo in the treatment of major depression in older patients. Our study in older patients reached the same conclusion.2 We used lofepramine, a prodrug of nortriptyline, in our study because it has less anticholinergic activity and is more suitable for older patients. Lofepramine is available in western Europe but not in the United States. We found that patients with minor depression also responded to the placebo.

In the study by Reynolds et al, nortriptyline was titrated to a plasma steady-state level of 80 to 120 ng/mL. While this approach may be desirable in younger adults, it may not always be necessary in older adults. In our study, older patients with major depression responded to one third the recommended dose, ie, 70 mg per day. By and large, this practice is safer for older adults, . . . [Full Text of this Article]



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RELATED ARTICLE

Nortriptyline and Interpersonal Psychotherapy as Maintenance Therapies for Recurrent Major Depression: A Randomized Controlled Trial in Patients Older Than 59 Years
Charles F. Reynolds III, Ellen Frank, James M. Perel, Stanley D. Imber, Cleon Cornes, Mark D. Miller, Sati Mazumdar, Patricia R. Houck, Mary Amanda Dew, Jacqueline A. Stack, Bruce G. Pollock, and David J. Kupfer
JAMA. 1999;281(1):39-45.
ABSTRACT | FULL TEXT  






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