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Phenelzine and Amitriptyline: Effects on Symptoms of Neurotic Depression

Published online by Cambridge University Press:  29 January 2018

P. R. Rowan ,
E. S. Paykel  and
R. R. Parker
P. R. Rowan
Affiliation:
St George's Hospital, London SW17 0RE
E. S. Paykel
Affiliation:
St George's Hospital Medical School, London SW17 0RE
R. R. Parker
Affiliation:
Trinity College, Dublin; (formerly Research Fellow, St George's Hospital Medical School)
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Summary

A double-blind controlled trial of phenelzine, amitriptyline and placebo was carried out in out-patients suffering from depression or mixed anxiety and depression. After six weeks treatment both active drugs were clearly superior to placebo and of similar efficacy; therapeutic effects started to appear at two weeks. Comparisons on symptom ratings showed that both drugs acted as true antidepressants, producing their greatest effects on ratings of depressive mood and thought content. There were additional weak differences, phenelzine producing more improvement on anxiety ratings, while amitriptyline gave greater effects on depressive impairment of work and interests and anergia. Analyses showed little evidence of clinical subgroups responding preferentially to either drug. The findings indicate that MAO inhibitors and tricyclic antidepressants have more closely similar clinical effects than has been thought and that either may be a useful treatment for these patients who are often considered to respond poorly to antidepressant drug treatment.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 140 , Issue 5 , May 1982 , pp. 475 - 483
Copyright
Copyright © Royal College of Psychiatrists, 1982 

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References

Bielski, R. J. & Friedel, R. O. (1976) Prediction of tricyclic antidepressant response. A critical review. Archives of General Psychiatry, 33, 1479–89.CrossRefGoogle ScholarPubMed
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–74.CrossRefGoogle Scholar
Derogatis, L. R., Lipman, R. S., Rickels, K. et al (1974) The Hopkins Symptom Checklist (HSCL). A self-report symptom inventory. Behavioural Science, 19, 1—15.Google Scholar
Greenblatt, M., Grosser, G. H. & Wechsler, H. (1962) A comparative study of selected antidepressant medications and ECT. American Journal of Psychiatry, 119, 144–53.CrossRefGoogle Scholar
Johnstone, E. C., Cunningham, O. D. G., Frith, C. D. et al (1980) Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychological Medicine, 10, 321–8.Google Scholar
Kay, D. W. K., Garside, R. F. & Fahy, T. J. (1973) A double-blind trial of phenelzine and amitriptyline in depressed out-patients. A possible differential effect of the drugs on symptoms. British Journal of Psychiatry, 123, 63–7.Google Scholar
Kiloh, L. G., Ball, J. R. B. & Garside, R. G. (1962) Prognostic factors in treatment of depressive states with imipramine. British Medical Journal, i, 1225–7.Google Scholar
Klein, D. F. & Davis, J. M. (1969) Diagnosis and Drug Treatment of Psychiatric Disorders. Baltimore: Williams Wilkins.Google Scholar
Marks, I. M., Stern, R. S., Mawson, D. et al (1980) Clomipramine and exposure for obsessive-compulsive rituals: I. British Journal of Psychiatry, 136, 1—25.CrossRefGoogle Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. British Medical Journal, i, 881–6.Google Scholar
Morris, J. B. & Beck, A. T. (1974) The efficacy of antidepressant drugs. A review of research (1958—1972). Archives of General Psychiatry, 30, 667–74.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799—812.Google Scholar
Overall, J. E., Hollister, L. E., Johnson, M. & Pennington, V. (1966) Nosology of depression and differential response to drugs. Journal of the American Medical Association, 195, 946–8.Google Scholar
Paykel, E. S. (1971) Classification of depressed patients: a cluster analysis derived grouping. British Journal of Psychiatry, 118, 275–88.Google Scholar
Paykel, E. S. (1979) Predictors of treatment response. In Psychopharmacology of Affective Disorders (eds. Paykel, E. S. and Coppen, A.). Oxford: University Press.Google Scholar
Paykel, E. S., Klerman, G. L. & Prusoff, B. (1970) Treatment setting and clinical depression. Archives of General Psychiatry, 22, 11—21.Google Scholar
Paykel, E. S., DiMascio, A., Haskell, D. & Prusoff, B. A. (1975) Effects of maintenance amitriptyline and psychotherapy on symptoms of depression. Psychological Medicine, 5, 57—77.Google Scholar
Paykel, E. S., Rowan, P. R. & Parker, R. R. (1982) Response to phenelzine and amitriptyline in subtypes of outpatient depression. (In press: Archives of General Psychiatry). Google Scholar
Paykel, E. S., Rowan, P. R. Rao, B. M. & Bhat, A. (in press) Atypical depression: nosology and response to antidepressants. In Treatment of Depression: Old Controversies and New Approaches (eds. Clayton, P. and Barrett, J. M.). Raven Press: New York.Google Scholar
Paykel, E. S., Parker, R. R., Penrose, R. J. J. & Rassaby, E. R. (1979) Depressive classification and prediction of response to phenelzine. British Journal of Psychiatry, 134, 572–81.Google Scholar
Raskin, A., Reatig, N. & McKeon, J. (1970) Differential response to chlorpromazine, imipramine and placebo. A study of sub-groups of hospitalized depressed patients. Archives of General Psychiatry, 23, 164–73.Google Scholar
Ravaris, C. L., Robinson, D. S., Ives, J. O. et al (1980) Phenelzine and amitriptyline in the treatment of depression. A comparison of present and past studies. Archives of General Psychiatry, 37, 1075–80.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L., Ives, J. O. & Lamborn, K. R. (1974) Treatment response to MAO inhibitors: relation to depressive typology and blood platelet MAO inhibition. In Classification and Prediction of Outcome of Depression (ed. Angst, J.). Stuttgart: Schattauer Verlag.Google Scholar
Sheehan, D. V., Ballenger, J. & Jacobsen, G. (1980) Treatment of endogenous anxiety with phobic, hysterical and hypochondriacal symptoms. Archives of General Psychiatry, 37, 51–9.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria. Archives of General Psychiatry, 35, 777–82.Google Scholar
Taves, D. R. (1974) Minimization: a new method of assigning patients to treatment and control groups. Clinical Pharmacology and Therapeutics, 15, 443–53.Google Scholar
Tyrer, P. (1976) Towards rational therapy with monoamine oxidase inhibitors. British Journal of Psychiatry, 128, 354–60.CrossRefGoogle ScholarPubMed
West, E. D. & Dally, P. J. (1959) Effects of iproniazid in depressive syndromes. British Medical Journal, i, 1491–4.Google Scholar
Young, J. P. R., Lader, M. H. & Hughes, W. C. (1979) Controlled trial of trimipramine, monoamine oxidase inhibitors, and combined treatment in depressed outpatients. British Medical Journal, ii, 1315–17.Google Scholar
Zitrin, C. M., Klein, D. F. & Woerner, M. G. (1980) Treatment of agoraphobia with group exposure in vivo and imipramine. Archives of General Psychiatry, 37, 63—72.Google Scholar
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