Iproniazid in Angina Pectoris

Abstract

There has beell considerable recent interest ill the treatment of anginla pectoris witlh iproniazid. In this paper the results of a careful double-blind study of its effect are evaluated.

Iproniazid, Nia'amide, and Meprobamate in Angina Pectoris

“…In addition the apparent usefulness of iproniazid in the treatment of angina has been severely limited by the development of liver damage, which has been estimated at I out of every 3,000-4,000 cases treated, with a mortality rate of 20-25% (Jolly, 1959). Although Shoskes et al (1959) reported a significant improvement of the symptoms of angina with a low dosage (50 mg. daily) without any incidence of liver damage, other less toxic mono-amine oxidase inhibitors were clearly required (Master and Donoso, 1959). …”

“…Allowance has to be made, on the one hand, for the initial improvement to be articipated as a result of the extra care implicit in any clinical trial (Cole et al. 1957), and, on the other hand, for the delay in the effect of mono-amine oxidase inhibitors, which may be as long as 10-14 days after beginning therapy, and which may persist for a similar period after ending therapy (Shoskes et al, 1959;Master and Donoso, 1959). To reduce the effect of these conflicting factors to a minimum in assessing the value of the different types of treatment, it was decided to use only the number of attacks of pain recorded during the last three weeks of each six-week perrod of treatment.…”

“…The small but reportedly effective dose of 50 mg. (Shoskes et al, 1959) was therefore chosen. Similarly, relatively small but reportedly effective daily doses of nialamide 100 mg. (Wolffe and Shubin, 1959) and meprobamate 400 mg. (Shapiro, 1957) were selected.…”

“…In one of the few controlled trials of iproniazid which showed a significant improvement in the symptoms of angina pectoris (Shoskes et al, 1959), the order of giving the unknown tablets appears to have significantly influenced the outcome of the trial. In this study, however, where the order of administering the tablets did not produce significantly different results, we have been unable to confirm their findings.…”