A detailed analysis of the results of a multi-centre clinical trial shows that, while the relapse rate following recovery from an operationally defined depressive illness was smaller among patients subsequently treated with either amitryptiline or lithium than with a placebo, there was no clinically significant difference between the prophylactic efficacy of the 2 antidepressants. An account is given of the relative adverse effects of the treatments, and the implications of the findings are discussed.
c1 Address for correspondence: Professor Michael Shepherd Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
p1 Present address: Craig Dunain Hospital, Inverness IV3 6JU.
p2 Present address: MRC Biostatistics Unit, Hills Road, Cambridge CB2 2QH.