Lazarus L W, Davis J M, Dysken M W
Geriatrics. 1985 Jun;40(6):43-8, 52-3.
In the apathetic, withdrawn patient, tricyclic secondary amines such as desipramine and nortriptyline are as efficacious as tricyclic tertiary amines, and they offer the advantage of fewer anticholinergic and sedating side effects. Depressions usually have a sudden onset, whereas degenerative dementias such as Alzheimer's disease and multi-infarct dementia are manifested gradually. However, many elderly demented patients have concomitant depression, making assessment difficult.
在冷漠、孤僻的患者中，去甲丙咪嗪和去甲替林等三环类仲胺与三环类叔胺的疗效相同，且具有抗胆碱能和镇静副作用较少的优势。抑郁症通常起病突然，而阿尔茨海默病和多发梗死性痴呆等退行性痴呆则逐渐显现。然而，许多老年痴呆患者同时伴有抑郁症，这使得评估变得困难。
