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A Double-Blind Comparison of Lithium Carbonate and Maprotiline in the Prophylaxis of the Affective Disorders

Published online by Cambridge University Press:  29 January 2018

Alec Coppen
Affiliation:
Medical Research Council Neuropsychiatry Laboratory, West Park Hospital, Epsom, Surrey
S. A. Montgomery
Affiliation:
Medical Research Council Neuropsychiatry Laboratory, West Park Hospital, Epsom, Surrey
R. K. Gupta
Affiliation:
Medical Research Council Neuropsychiatry Laboratory, West Park Hospital, Epsom, Surrey
J. E. Bailey
Affiliation:
Medical Research Council Neuropsychiatry Laboratory, West Park Hospital, Epsom, Surrey

Summary

A double-blind prospective study was carried out comparing the prophylactic effect of maprotiline and lithium carbonate over a period of one year in patients suffering from recurrent affective disorders. The average Affective Morbidity Index was lower, but not significantly so, in patients treated with lithium. A further analysis, based on dividing patients into those with no affective morbidity and those who showed some affective morbidity during the study, demonstrated lithium carbonate to be significantly superior to maprotiline both in the group as a whole and in unipolar depressives. A correlation between high plasma maprotiline concentration and low morbidity was observed and was in line with an earlier report. A highly significant negative correlation (r = −0.97; p < 0.001) was found between plasma maprotiline concentration and body weight. Although the results showed lithium carbonate to be superior to maprotiline in the study, it should be emphasized that the plasma levels of lithium were constantly monitored and maintained at what is considered to be its optimum concentration, whereas the maprotiline treated patients were kept on a fixed dosage regime irrespective of plasma levels.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1976 

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References

Angst, J. & Rothweiler, R. (1974) Classification and Prediction of Outcome of Depression (cd. Angst, J.). Stuttgart-New York: F. K. Schattauer Verlag.Google Scholar
Baastrup, P. C., Poulsen, J. C., Schou, M., Thomsen, K. & Amdisen, A. (1970) Prophylactic lithium: double-blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet, ii, 326–30.Google Scholar
Beck, A. J., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961) An inventory for measuring depression. Arch. gen. Psychiat., 4, 561–71.Google Scholar
Braithwaite, R., Goulding, R., Theano, G., Bailey, J. & Coppen, A. (1972) Plasma concentration of amitriptyline and clinical response. Lancet, i, 12971300.Google Scholar
Coppen, A., Noguera, R., Bailey, J., Burns, B., Swani, M., Hare, E. & Gardner, R. (1971) Prophylactic lithium in affective disorders–a controlled trial. Lancet, ii, 275–9.CrossRefGoogle Scholar
Coppen, A., Peet, M., Bailey, J., Noguera, R., Burns, B., Swani, M., Maggs, R. & Gardner, R. (1973) Psychiat. Neurol. Neurochir. (Amst.), 76, 501–10.Google Scholar
Cundall, R. L., Brooks, P. W. & Murray, L. G. (1972) A controlled evaluation of lithium prophylaxis in affective disorders. Psychol. Med., 2, 308–11.CrossRefGoogle ScholarPubMed
Hullin, R. P., McDonald, R. & Allsopp, M. (1972) Prophylactic lithium in recurrent affective disorders. Lancet, i, 1044–6.Google Scholar
Kielholz, P. (1972) Depressive Illness (ed. Kielholz, P.). Bern: Hans Huber.Google Scholar
Klerman, G. L., Dimascio, A. & Weissman, M. (1974) Treatment of depression by drugs and psychotherapy. Amer. J. Psychiat., 131, 186–91.Google Scholar
Kraugh-Sørensen, P., Asberg, M. & Eggert-Hansen, L. (1973) Plasma nortriptyline levels in endogenous depression. Lancet, i, 113.CrossRefGoogle Scholar
Mindham, R. H. S., Howland, C. & Shepherd, M. (1973) An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychol, Med., 3, 517.Google Scholar
Prien, R. F., Caffey, E. M. & Klett, J. (1973) Prophylactic efficacy of lithium carbonate in manic-depressive illness. Arch. gen. Psychiat., 28, 337–41.Google Scholar
Prien, R. F., Klett, J. & Caffey, E. M. (1973) Litihum carbonate and imipramine in prevention of affective episodes. Arch. gen. Psychiat., 29, 420–5.Google Scholar
Reiss, W. (1974) Analyt. Chim. Acta, 68, 363–76.Google Scholar
Stallone, F., Shelley, E., Mendlewicz, J. & Fieve, R. R. (1973) The use of lithium in affective disorders. III. A double-blind study of prophylaxis in bipolar illness. Amer. J. Psychiat., 130, 1006–10.Google Scholar
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