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May 26, 1999

Dose of Tricyclic Antidepressants in Elderly Patients

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(20):1891-1892. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-20-jbk0526

To the Editor: Dr Reynolds and colleagues1 concluded that nortriptyline, a tricyclic antidepressant, was superior to placebo in the treatment of major depression in older patients. Our study in older patients reached the same conclusion.2 We used lofepramine, a prodrug of nortriptyline, in our study because it has less anticholinergic activity and is more suitable for older patients. Lofepramine is available in western Europe but not in the United States. We found that patients with minor depression also responded to the placebo.

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