Abstract
Objective: To manage a treatment resistant depression, clinicians may add a second medication to the first antidepressant drug. The aim of the current research was to study the outcome of augmentation of citalopram with nortryptiline or triiodothyronine in a randomized clinical trial.
Methods: We selected 48 adult outpatients with a diagnosis of non-psychotic major depressive disorder who had not responded to 12 weeks citalopram therapy (40 mg per day). They were randomly allocated to two groups. One group received nortryiptiline (at a dose of up to 150 mg per day) and the other triiodothyronine (T3) (at a dose of up to 50 µg per day). The remission of depression was defined as a score of 7 or less on the 17-item Hamilton Rating Scale for Depression (HRSD-17).
Results: After 8 weeks, the nortriptyline group had a higher remission rate (33.33 %) than the triiodothyronine group (17.64%). The nortriptyline group, however, had a higher dropout rate due to experiencing more side effects
Conclusion: Augmentation of citalopram with nortryptiline seems to be effective in the management of treatment resistant depression. However, one should strike a balance between the efficacy and the tolerability of this approach, as there is a higher chance of experiencing side effects by the patients.
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© 2007, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.