Major Depression | Melancholia or Severe Depression | Anxious Depression | Atypical Depression | Psychotic Depression | Bipolar Depression | Chronic Major Depression and Dysthymia | Late-Life Depression | Depression in Children | Obsessive-Compulsive Disorder | Panic Disorder | Attention-Deficit/Hyperactivity Disorder | Pain Syndromes | Other Indications
The efficacy of the tricyclic and tetracyclic compounds in major
depression is well established. The evidence for their effectiveness
has been reviewed previously (Agency for Health Care Policy and Research 1993; Davis and Glassman 1989).
Imipramine is the most extensively studied tricyclic antidepressant,
in part because for many years it was the standard agent against
which other new drugs were compared. In 30 of 44 placebo-controlled
studies, imipramine was more effective than placebo. If data from these
studies are combined, 65% of 1,334 patients completing treatment
with imipramine were substantially improved, whereas 30% of
those on placebo improved. Intention-to-treat response
rates for placebo-controlled studies of imipramine in outpatients
were 51% for imipramine and 30% for placebo (Agency for Health Care Policy and Research 1993). In most comparison
studies, the other tricyclic and tetracyclic antidepressants have been
found to be comparable to imipramine in efficacy.