Clinical Efficacy of the Newer Antidepressants

Abstract

Tricyclics and monoamine oxidase inhibitors are effective antidepressants, but in many cases they are prescribed somewhat uneasily because of their potentially serious side effects. Many of the compounds being developed and tested offer the promise of effectiveness without the unpleasant anticholinergic or worrisome cardiovascular effects of the tricyclics. A few of these new agents have demonstrated particular efficacy in certain depressive subtypes. For example, nomifensine and bupropion may be especially useful in psychomotor retarded depression. Thus, we are possibly entering an era of greater specificity in drug management of depression. Because these new compounds have a lower side effect profile than the established agents, there should be greater patient compliance. Long term studies also indicate sustained efficacy with agents such as trazodone. One new agent, maprotiline, has been approved in the United States, and others will soon follow. It will be important for clinicians to become familiar with these new antidepressants, so that they can be used to their fullest advantage.