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Adding lithium to tricyclic antidepressant treatment for depression converts a sizable proportion of nonresponders to responders. This study tried to determine whether initial lithium augmentation would improve antidepressant response in 40 nonresistant DSM-III-R bipolar melancholic-type-depressed inpatients.
None of the patients had been treated with lithium or had received an antidepressant for the current depressive episode. Half the patients were treated with amitriptyline (225 mg per day with serum levels adjusted after one week to approximately 200 ng/ml) plus lithium carbonate (900 mg daily) for five weeks. The other half were matched for the duration of the current episode and illness severity and treated with the identical amitripty…