Paykel E S, DiMascio A, Klerman G L, Prusoff B A, Weissman M M
Pharmakopsychiatr Neuropsychopharmakol. 1976 May;9(3):127-39. doi: 10.1055/s-0028-1094487.
This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressive responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly to no medication, with and without individual psychotherapy from social workers in the factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustment after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest that tricyclic antidepressants should be routinely continued for several months after drug-induced remission.
本文总结了一项针对以神经症性抑郁为主的患者进行维持治疗的研究结果，这些患者最初对阿米替林治疗有反应。患者持续服用阿米替林八个月，两个月后双盲撤药换用安慰剂，或直接撤药不服用任何药物，在析因设计中有无社会工作者提供的个体心理治疗。与早期撤药的任何一种情况相比，持续治疗显著降低了早期复发和症状复现。在未复发的患者中，心理治疗在八个月后改善了社会适应，且无任何显著交互作用。除了对碳水化合物的渴望外，副作用极小。这些发现表明，在药物诱导缓解后，三环类抗抑郁药应常规持续服用数月。
