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A Comparison of Present and Past Studies

C. Lewis Ravaris, MD, PhD; Donald S. Robinppson, MD; John O. Ives, MD; Alexander Nies, MD; Diantha Bartlett, MS

Arch Gen Psychiatry. 1980;37(9):1075-1080.

Abstract
• We present the results of a direct comparison of phenelzine sulfate and amitriptyline hydrochloride therapy in 105 depressed patients. We believe this is the first definitive double-blind controlled clinical trial of a monoamine oxidase inhibitor and a tricyclic antidepressant in the outpatient setting. The results show both antidepressants to be effective, with the similarities between the two exceeding the differences. Both drugs had marked antidepressant and antianxiety effects. Phenelzine tended to exert a stronger antianxiety action; amitriptyline was more effective in reversing weight loss and improving sleep. The incidence of two side effects, sedation and orthostatic hypotension, was almost identical. Dry mouth was more prevalent with amitriptyline. We discuss the indications for the differential clinical use of both drugs in depressed outpatients.

Author Affiliations
From the Department of Psychiatry, East Carolina University School of Medicine, Greenville, NC (Dr Ravaris); the Departments of Pharmacology, Medicine, and Psychiatry, Marshall University School of Medicine, Huntington, WVa (Drs Robinson and Nies); and the Department of Psychiatry and the Biometry Facility, University of Vermont College of Medicine, Burlington (Dr Ives and Ms Bartlett).

Footnotes
Accepted for publication Sept 26, 1979.

Read in part before the VI World Congress of Psychiatry, Honolulu, August 1977.

Reprint requests to Department of Psychiatry, East Carolina University School of Medicine, Greenville, NC 27834 (Dr Ravaris).

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