Abstract
In a multicenter, placebo-controlled, clinical trial, the efficacy of Limbitrol was compared with that of its components, amitriptyline and chlordiazepoxide. All patients had a diagnosis of primary depression. Data from 279 patients were evaluated using the Hamilton depression scale, the Beck depression inventory, and physician and patient global change measures.
Statistically significant differences favoring Limbitrol occurred after 1 week of treatment, and a trend in favor of Limbitrol continued throughout the remaining 3 weeks. In most efficacy comparisons, the combination was as good as, or better than, amitriptyline alone. It was superior to chlordiazepoxide alone after 2 and 4 weeks of treatment. Each component produced an independent contribution to the total therapeutic effect: the chlordiazepoxide effect was more prominent in the first 2 weeks and the amitriptyline effect in the latter 2 weeks. A trend favoring amitriptyline over chlordiazepoxide was evident by week 4.
The overall incidence of side effects was comparable in both Limbitrol- and amitriptyline-treated groups. Limbitrol-treated patients exhibited more sedation, but significantly fewer Limbitrol patients discontinued treatment prematurely because of side effects.
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References
Asberg, M.: Relationship between plasma level and therapeutic effect of nortriptyline. Br. Med. J. 3, 331–334 (1971)
Blackwell, B.: Drug therapy: patient compliance. N. Engl. J. Med. 289, 249–252 (1973)
Braithwaite, R.: Plasma concentration of amitriptyline and clinical response. Lancet I1972, 1297–1300
Feighner, J. P.: Diagnostic criteria for use in psychiatric research. Arch. Gen. Psychiatry 26, 57–63 (1972)
Glassman, A. H.: Clinical implications of imipramine plasma levels for depressive illness. Arch. Gen. Psychiatry 34, 197–204 (1977)
Haider, I.: A comparative trial of Ro 4-6270 and amitriptyline in depressive illness. Br. J. Psychiatry 113, 993–998 (1967)
Hare, H. P., Jr.: Comparison of chlordiazepoxide-amitriptyline combination with amitriptyline alone in anxiety-depressive states. J. Clin. Pharmacol. 11, 456–460 (1971)
Hollister, L. E., Overall, J. E.: Reflections on the specificity of action of antidepressants. Psychosomatics 6, 361–365 (1965)
Hordern, A.: Amitriptyline in depressive states: phenomenology and prognostic considerations. Br. J. Psychiatry 109, 815–825 (1963)
Jenner, F. A.: A controlled trial of methaminodiazepoxide (chlordiazepoxide, “Librium”) in the treatment of anxiety in neurotic patients. J. Ment. Sci. 107, 575–582 (1961)
Lasagna, L.: Fault and default. N. Engl. J. Med. 289, 267–268 (1973)
Rickels, K.: Drug treatment in depressive illness (amitriptyline and chlordiazepoxide in two neurotic populations). Dis. Nerv. Syst. 31, 30–42 (1970a)
Rickels, K., Hesbacher, P., Downing, R. W.: Differential drug effects in neurotic depression. Dis. Nerv. Syst. 31, 468–475 (1970b)
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Feighner, J.P., Brauzer, B., Gelenberg, A.J. et al. A placebo-controlled multicenter trial of Limbitrol versus its components (amitriptyline and chlordiazepoxide) in the symptomatic treatment of depressive illness. Psychopharmacology 61, 217–225 (1979). https://doi.org/10.1007/BF00426739
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DOI: https://doi.org/10.1007/BF00426739