In conducting drug trials nowadays one is aware of at least some of the difficulties that have to be faced and the possible traps lying ahead. It is probably true to say that perfection is unattainable in trials of this nature because of the unpredictability of the human material concerned—both the tested and the observers sharing this common fallibility. It is necessary to attempt so to arrange the experiment that the magnitude of the errors is kept to a minimum and the results remain unobscured.

A double-blind controlled trial of iproniazid in endogenous depression and a comparison of its effects with those of E.C.T. was reported in this journal by Kiloh et al. (1960). To summarize the results—of 26 patients treated with iproniazid a good immediate response was found in 14 cases (54 per cent.) whereas only 3 of 28 patients (11 per cent.) given placebo tablets showed a significant improvement at the end of three weeks. Of 27 patients treated with E.C.T. 24 (89 per cent.) showed a good immediate response.

Despite the good results reported in recent years in many cases of chronic schizophrenia following the use of tranquillizing drugs, there remains in mental hospitals a group of chronic and often deteriorated patients who have shown a strong resistance to all forms of treatment. In many such cases disturbances of behaviour are modified and sometimes controlled by such drugs as chlorpromazine and reserpine. Nevertheless, the overall situation is far from satisfactory and the search for more effective drugs continues.

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