Efficacy, safety, and indications for tricyclic and newer antidepressants

The availability of several different classes of medication provides practitioners with various alternatives for the treatment of depression and associated disorders. Factors to be considered in the initial choice of an antidepressant include efficacy, side effects (both short and long term), safely in overdose, and range of therapeutic action. These features are reviewed for the standard tricyclic anti‐depressants (TCAs) and monoamine oxidase inhibitors (MAOIs), as well as for the newer selective serotonin reuptake inhibitors (SSRIs) and reversible inhibitors of monoamine oxidase (RIMAs). The SSRIs have demonstrated efficacy equivalent to TCAs, but possess more favorable side effect profiles and are safer in overdose. Additional research is needed to clarify the relative advantages of SSRIs compared with the classical tricyclic antidepressants and monoamine oxidase inhibitors, and to inform clinical decision‐making. Depression 2:127–131 (1994/1995).