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Are TCAs more effective than SSRIs?

Posted by Skeletor on June 6, 2020, at 20:07:00

Are TCAs more effective than SSRIs? In your experience...

"Since the introduction of the SSRIs, it has been repeatedly observed that severely depressed inpatients, usually those with melancholia, show a more robust response to TCAs than to SSRIs. The first studies to demonstrate this were by the Danish University Antidepressant Group, which published 2 widely cited studies showing the superiority of the TCA clomipramine to 2 SSRIs, citalopram and paroxetine, in hospitalized patients who had depression.19,20 Subsequent studies replicated the finding that TCAs are superior to SSRIs in specific populations.... 21-23" - source:

It would seem so, at least according to many studies... Gillman regularly mentions that his patients did substantially better on TCAs than on SSRIs (Sertraline might be an exception). Especially Amitriptyline, Clomipramine and Imipramine seem to be superior in effectivity. Is it wise to completely shun those very effective older antidepressants?




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