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104 patients suffering from neurotic or reactive depression were treated with either alprazolam or amitriptyline in randomised, double-blind fashion. Seventeen patients were either lost to follow-up or withdrawn before week 2 (13 due to side effects and 1 because she was feeling better). A further 7 patients did not comply with the protocol, giving a total of 24 patients whose data were not considered suitable for inclusion in the analysis of therapeutic assessments. Evaluation of the 80 patients (40 in each group) who completed at least 2 weeks of the 4-week study demonstrate that both treatments produced a statistically significant response rate. There was a more rapid effect in those patients who received amitriptyline, but there was no significant difference in response between the treatment groups after 4 weeks treatment. Analysis of safety and side effect data on 101 patients (50 treated with alprazolam and 51 with amitriptyline) shows no statistically significant difference in the overall number of side effects experienced in each group, although 11 of those patients who received amitriptyline withdrew because of adverse reactions before completing the study compared to 6 in the alprazolam group. These results suggest that alprazolam may be a useful treatment for patients with neurotic or reactive depression not requiring hospitalisation.

Objective: No studies have yet evaluated whether light therapy or negative ion therapy can be used as maintenance treatment after acute treatment with antidepressants in patients with major depressive disorder. To address the importance of this question, we surveyed participants with depression to determine their knowledge and attitudes about light therapy and negative ion therapy, and their willingness to participate in a randomized clinical trial with these therapies substituting for antidepressants for maintenance treatment. Methods: Participants with a self-reported diagnosis of depression were recruited by email, newsletters, and social media to complete an online survey with questions about awareness and effectiveness of light therapy and negative ion therapy for depression. Vignettes describing the use of these therapies for maintenance treatment were presented with follow up questions about the ease of use and reasons for wanting (and not wanting) to use the therapies instead of antidepressants. Another vignette described a randomized study with these therapies followed by questions on whether participants would likely volunteer for the study. Chi-square tests were used to examine differences in responses between therapies. Results: A total of 221 participants completed the survey. Most of them were aware of both therapies, but more participants had heard of light therapy (95% compared to 62% for negative ion therapy, p<0.0001), had used light therapy (28% versus 16%, p<0.003), and regarded light therapy as effective (54% versus 37%, p<0.001). Both therapies were considered easy to use. The majority of participants (78%) thought that it was important to find non-medication therapies for maintenance treatment, and 77% responded that they would likely volunteer for a randomized study to determine efficacy of the two therapies for maintenance treatment. Conclusion: People with depression are generally aware of light therapy and negative ion therapy and believe they would be good therapies to substitute for antidepressants in maintenance treatment. These findings support the importance and feasibility for a randomized relapse prevention trial with light therapy and negative ion therapy in patients with depression.

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