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Whether selective serotonin reuptake inhibitors (SSRIs) are as effective as tricyclic antidepressants (TCAs) in treating severe depression is still controversial. These two studies add to the controversy.
The first study, a multicenter, double-blind trial, compared the efficacy of the SSRI paroxetine with the TCA amitriptyline in 153 hospitalized patients (aged 18 to 65) suffering from DSM III major depression, melancholic subtype, in seven centers in Austria and Germany. Depression was rated using the Hamilton Depression scale (HAM-D), the Montgomery Asberg scale (MADRS), and the Clinical Global Impression Scale (CGI). At study entry, all patients scored above 18 on the HAM-D scale.
Patients pretreated with tricyclic or tetracyclic antidepre…