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Study:Amitriptyline most effective, experiences?

Posted by mtom on May 29, 2019, at 9:18:26

A large review and meta-analysis study was published in Lancet in 2018 comparing 21 Antidepressants for efficacy and acceptability.

Amitriptyline came out best for efficacy, but had a high drop-out rate.

They included 522 double blind studies with 117,000 patients. However the number of patients/studies for each drug varied considerably which impacted the quality of evidence, as did risk of bias (all discussed in the paper).

Scroll down to pages 1363 for table if you don't want to read the whole thing (although worthwhile). There is also a table on p 364 which I'm finding difficult to interpret.

Also see "Findings" on the first page.

Doctors seem unwilling to prescribe this these days. I know there are toxicity issues with high doses, also somnolence and weight gain side effects - which seem to be the main reason for drop outs.

I took amitriptyline low dosage many years ago when a period of situational stress started bringing on depression and panic attacks. I felt rough with side-effects the first couple of weeks, then these improved - except I did continue to experience somnolence (worse in the mornings) and considerable weight gain. However I did also start feeling better BUT I concurrently resolved the situational stresses which may have had more to do with my improvement than the drug. I stopped taking it after 8 months.

I was depression free for many years until it came on very suddenly and for no apparent reason just prior to being diagnosed with an autoimmune disorder, which I believe caused the depression.

I have tried other antidepressants since, with little to no benefit, and lots of side-effects including intense anxiety which does not resolve over time.

I'm interested in hearing of others experiences with amitriptyline.




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