Amitriptyline therapeutic efficacy

In a double-blind comparison of noxiptiline (n = 30) and amitriptyline (n = 32) in hospitalized patients with primary depressive illness for 3-6 weeks there were no significant differences, but noxiptiline had a faster onset of action (1). A comparison with imipramine also showed no difference in therapeutic efficacy (2). 

Dothiepin (Dosulepin) is the thio isostere of doxepin and is marketed in Europe as its single E-geometric isomer (Fig. 21.1 7), in contrast to the active Z-geometric isomer for doxepin. Its antidepressant activity is mediated by inhibition of both the NET and SERT, with preferential affinity for SERT (65). It exhibits greater overall in vitro affinity for NET and SERT than its oxygen isostere doxepin, consistent with its greater potency. Its overall therapeutic efficacy is similar to that of amitriptyline. 

Amoxapine is less potent than other tricyclic antidepressants, with a therapeutic dosage range of 75-600 mg/day (usually 200-400 mg/day). Clinical effects have not been consistently correlated with plasma concentrations, but amoxapine has similar efficacy to other tricyclic antidepressants in heterogeneous populations of depressed patients. Controlled comparisons have shown that its clinical profile is very similar to that of imipra-mine (3) and that it is somewhat less sedative than amitriptyline (4-6). In two of these studies (4,6) the... 

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