Clinical trials suggest that SSRIs and tricyclics are about equal in their antidepres-sant properties, although some patients respond better to one or other type of drug. However, patients included in commercial drug trials tend to be toward the milder end of the spectrum. Some trials have excluded, for example, those with suicidal risk or comorbid conditions. Clinical experience is that severely depressed patients, especially those whose sleep is disturbed, respond better to a sedative tricyclic or other drug than to an SSRI.

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