Recurrence of depression after discontinuation of long-term amitriptyline treatment

Abstract
In this study 10 of 17 patients receiving long-term amitriptyline [an antidepressant] treatment (average duration: 3.7 yr, average dose; 138 mg) had their medication tapered and discontinued under double-blind conditions. Eight became depressed within 3-15 wk. None of the 7 control subjects became depressed during the 6 mo. of the study. Those who became depressed also showed psychomotor retardation and sleep disturbance. Relief of longstanding anticholinergic side effects followed medication discontinuation. Some patients whose amitryptyline was discontinued experienced a mild withdrawal syndrome within the first 2 wk, consisting of irritability, dream and sleep distrubance, and restlessness during the first few wk.