Symptom reduction in depressed outpatients treated with amitriptyline or maprotiline: Repeated measurement analysis

Preliminary open-labeled studies¹ had characterized maprotiline (Ludiomil^®) as a tetracyclic antidepressant that enhanced both mood and drive, reduced the symptoms of agitation and retardation, and had a fast onset of action. These effects might appear in patients as an increased interest in the environment and decreased apathy during the initial weeks of treatment. To test this observation, maprotiline was compared to amitriptyline hydrochloride (Elavil^®), a conventional tricyclic, in a 4-week double-blind clinical trial with outpatient depressives.No difference between these two compounds in timing of response, efficacy, or side effects was shown after 1 week of treatment or at the completion of the trial,² when utilizing a standard analysis of covariance. Using a repeated measurement analysis, we then examined the differences in rates of change between the drugs. Since the repeated measurement analysis uses the total period of observation instead of discrete points in time, it may be more sensitive to detecting those differences that were hypothesized prior to initiating the study.This paper will demonstrate the use of repeated measurement analysis to compare rates, pattern, and timing of symptom change between maprotiline and amitriptyline over the 4 weeks of treatment.