Drug therapy in depressions: Controlled evaluation of imipramine, isocarboxazide, dextroamphetamine‐amobarbital, and placebo

Abstract

Controlled evaluation of imipramine, isocarboxazide, dextroamphetamine-amobarbital, and placeboAn evaluation of imipramine, isocarboxazide, dextroamphetamine-amobarbital, and placebo was carried out in 204 patients with depressive syndromes in thirty-two Veterans Administration Hospitals. Treatment with a fixed dosage schedule was followed for 3 weeks, the dosage becoming flexible during an ensuing 9 week period. Evaluation of responses was made by three rating scales specially derived for depressed patients.After 3 weeks of treatment, imipramine was significantly more effective than the other three treatments as measured only by a thirty-one item expert clinician's scale derived from the Inpatient Multidimensional Psychiatric Scale. Favorable responses to imipramine were often prompt, leading to loss of such patients from the study before the full 12 week treatment period had been completed. After 12 weeks of treatment, the patients who remained in all four treatment groups were significantly improved when each group was compared with its pretreatment level, but there were no statistically reliable differences between treatments at the end of the study. These results emphaSize the need for controlled 5tudies in depreSsive syndromes subject to spontaneous improvement.

Depressive Illness in a General Practice. A Demographic Study and a Controlled Trial of Imipramine

“…Shepherd et al (1966) (Ball and Kiloh, 1959;Daneman, 1961;Abraham et al, 1963;Medical Research Council, 1965;Bassa and Vora, 1965) (Doust et al, 1959;Sloane et al, 1959;Roulet et al, 1962;Bassa and Vora, 1965;Friedman et al, 1966). In the remainder (Lehmann et al, 1958;Ball and Kiloh, 1959;Leyberg and Denmark, 1959;Holdway, 1960;Kenning et al, 1960;Miller et al, 1960;Agnew et al, 1961;Ashby and Collins, 1961;Daneman, 1961;Friedman et al, 1961;Hohn et al, 1961;Linford Rees et al, 1961;Rothman et al, 1961;Overall et al, 1962;Wittenborn et al, 1962;Abraham et al, 1963;Robin and Langley, 1964;Medical Research Council, 1965;Schorer et al, 1966) (Beck, 1967); instead, adverse verdicts have coincided with a waning interest and the drug has gained-on inadequate evidence-an established, if ill-defined, place in psychiatry.…”

“…Five out of the 24 trials have returned adverse verdicts (Doust et al, 1959;Sloane et al, 1959;Roulet et al, 1962;Bassa and Vora, 1965;Friedman et al, 1966). In the remainder (Lehmann et al, 1958;Ball and Kiloh, 1959;Leyberg and Denmark, 1959;Holdway, 1960;Kenning et al, 1960;Miller et al, 1960;Agnew et al, 1961;Ashby and Collins, 1961;Daneman, 1961;Friedman et al, 1961;Hohn et al, 1961;Linford Rees et al, 1961;Rothman et al, 1961;Overall et al, 1962;Wittenborn et al, 1962;Abraham et al, 1963;Robin and Langley, 1964;Medical Research Council, 1965;Schorer et al, 1966) the verdicts are either generally favourable or else the allocation is difficult.…”

The Monoamine Oxidase Inhibitor Isocarboxazid is a Relevant Treatment Option in Treatment-Resistant Depression-Experience-Based Strategies in Danish Psychiatry

“…The clinical efficacy of isocarboxazid was never well established in randomized controlled trials [1,8] and for many years the clinical specificity of monoamine oxidase inhibitors in so-called atypical depression was intensely, however, inconclusively studied [9][10][11].…”

Behavioral Improvement in the Older Schizophrenic Patient: Drug and Social Therapies*

“…The usefulness of phenothiazine therapy in younger, newly‐admitted schizophrenic patients already has been demonstrated in several studies (1–3). Our one major investigation of depressed patients showed that imipramine was the most effective agent tested (4). The situation was less clear regarding the effect of combined drug therapy in patients with chronic schizophrenia (5).…”