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Re: dothiepin as antidepressant » matze

Posted by SalArmy4me on June 19, 2001, at 15:51:03

In reply to dothiepin as antidepressant, posted by matze on June 19, 2001, at 12:53:05

Martin, Richard M. Hilton, Sean R. Kerry. General practitioners' perceptions of the tolerability of antidepressant drugs: a comparison of selective serotonin reuptake inhibitors and tricyclic antidepressants. BMJ. 314(7081):646-651, Mar 1, 1997:

"The newer tricyclic antidepressants (dothiepin and lofepramine), which may have greater tolerability, were also analysed separately. Their discontinuation ratio was 31.4% compared with 39.0% for older tricyclic antidepressants (P< 0.001). They also had lower discontinuation ratios for side effects compared with older tricyclics (12.9% v 18.0%; P< 0.0001)."

Tyrer, Peter FRCPsych et al. A Controlled Trial of Dothiepin and Placebo in Treating Benzodiazepine Withdrawal Symptoms. British Journal of Psychiatry. 168(4):457-461, Apr 1996:

"Twenty-nine (71%) of the 41 patients in the dothiepin group had at least one adverse event during the study compared with 26 (57%) of the 46 patients allocated to placebo. The average number of events reported was 4.1 with dothiepin treated patients and 3.6 for those treated by placebo. There was no statistically significant difference between treatments in the proportion of patients reporting adverse events."

Hotopf, Matthew MRCPsych. Lewis, Glyn PhD. Normand, Charles DPhil. Are SSRIs a Cost-Effective Alternative to Tricyclics? British Journal of Psychiatry. 168(4):404-409, Apr. 1996:

There are disadvantages of comparing groups of compounds against each other. Tricyclics are heterogeneous. Smaller meta-analyses have been done to compare individual drugs. Dothiepin has been compared against the SSRIs (Donovan et al, 1993). [10] The meta-analysis was based on three trials comparing fluoxetine with dothiepin and found that the drop-out rate for adverse events was lower for dothiepin. Unfortunately the authors did not perform a stratified analysis. We re-analysed their results using a Mantel-Haenzel method (i.e. fixed effects estimate; Mantel-Haenzel analysis allows a stratification of result by study, thus weighting the analysis in favour of larger studies) and the odds ratio for drop outs in fluoxetine versus dothiepin was 1.79 (95% CI 0.89-3.79, P=0.08; i.e. more drop-outs in fluoxetine, but not statistically significant).


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