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A Statistical Review of Controlled Trials of Imipramine and Placebo in the Treatment of Depressive Illnesses

Published online by Cambridge University Press:  29 January 2018

S. C. Rogers  and
P. M. Clay
S. C. Rogers
Affiliation:
The Hospital of St. Cross, Rugby
P. M. Clay
Affiliation:
West Midlands Regional Health Authority
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Summary

A method of reviewing a series of clinical trials by extracting the basic data in the form of 2 × 2 tables and analysing these by Fisher's two-tailed Exact Test is described, and illustrated by published imipramine-placebo trials.

The results suggest that the benefit of this drug in patients with endogenous depression who have not become institutionalized is indisputable, and that further drug-placebo trials in this condition are not justified.

Two of the three trials of imipramine in neurotic depression gave results showing significant improvement.

Possible explanations of the apparent failure of this drug in groups of patients with undifferentiated depression are discussed.

Type
Papers
Information
The British Journal of Psychiatry , Volume 127 , Issue 6 , December 1975 , pp. 599 - 603
Copyright
Copyright © Royal College of Psychiatrists, 1975 

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References

Abraham, H. C., Kanter, V. B., Rosen, I. & Standen, J. L. (1963) A controlled clinical trial of imipramine (Tofranil) with out-patients. British Journal of Psychiatry, 109, 286–93.Google Scholar
Agnew, P. C., Baran, I. D., Klapman, H. J., Reid, T. F., Stern, J. J. & Slutske, R. H. (1961) A clinical evaluation of four anti-depressant drugs (Nardil, Tofranil, Marplan and Deprol). American Journal of Psychiatry, 118, 160–2.Google Scholar
Armitage, P. (1971) Statistical Methods in Medical Research. Oxford and Edinburgh: Blackwell Scientific Publications.Google Scholar
Ashby, W. R. & Collins, G. H. (1961) A clinical trial of imipramine (Tofranil) on depressed patients. Journal of Mental Science, 107, 547–51.Google Scholar
Ball, J. R. B. & Kiloh, L. G. (1959) A controlled trial of imipramine in treatment of depressive states. British Medical Journal, ii, 1052–5.CrossRefGoogle ScholarPubMed
Bassa, D. M. & Vora, H. D. (1965) Evaluation of efficacy of imipramine in depressive disorders; a double-blind study. American Journal of Psychiatry, 121, 1116–17.Google Scholar
Clark, C. J. & Downie, C. C. (1966) A method for the rapid determination of the number of patients to include in a controlled clinical trial. Lancet, ii, 1357–8.CrossRefGoogle Scholar
Cole, J. O. (1964) Therapeutic efficiency of antidepressant drugs. Journal of the American Medical Association, 190, 448–55.Google Scholar
Daneman, E. A. (1961) Imipramine in office management of depressive reactions. Diseases of the Nervous System, 22, 213–17.Google Scholar
Doust, J. W. L., Lewis, D. J., Miller, A., Sprott, D. & Wright, R. L. D. (1959) Controlled assessment of antidepressant drugs including Tofranil. Canadian Psychiatric Association Journal, 4 (Special Supplement), S190–S194.CrossRefGoogle Scholar
Fink, M., Klein, D. F. & Kramer, J. C. (1965) Clinical efficacy of chlorpromazine—procyclidine combination, imipramine, and placebo in depressive disorders. Psychopharmacologia, 7, 27–36.Google Scholar
Fisher, R. A. (1934) Statistical Methods for Research Workers (5th edition). Section 21. 02. Edinburgh: Oliver and Boyd.Google Scholar
Friedman, A. S., Granick, S., Cohen, H. W. & Cowitz, B. (1966) Imipramine (Tofranil) vs. placebo in hospitalized psychotic depressives. Journal of Psychiatric Research, 4, 13–36.CrossRefGoogle ScholarPubMed
Friedman, C., De Mowbray, M. S. & Hamilton, V. (1961) Imipramine (Tofranil) in depressive states. A controlled trial with in-patients. Journal of Mental Science, 107, 948–53.CrossRefGoogle Scholar
Fryer, D. G. & Timberlake, W. H. (1963) A trial of imipramine (Tofranil) in depressed patients with chronic physical diseases. Journal of Chronic Diseases, 16, 173–8.Google Scholar
Gore, C. P. (1973) Clomipramine (Anafranil), Tofranil (Imipramine) and placebo; a comparative study in relation to electro-convulsive therapy. Journal of International Medical Research, 1, 347–51.CrossRefGoogle Scholar
Greenblatt, M., Grosser, G. H. & Wechsler, H. (1964) Differential response of hospitalized depressed patients to somatic therapy. American Journal of Psychiatry, 120, 935–43.CrossRefGoogle ScholarPubMed
Hare, E. H. (1966) Drugs in anxiety and depression. Clinical Medicine, 73, 57–8.Google Scholar
Heller, A., Zahourek, R. & Whittington, H. C. (1971) Effectiveness of anti-depressant drugs: a triple-blind study comparing imipramine, desipramine and placebo. American Journal of Psychiatry, 127, 1092–5.CrossRefGoogle Scholar
Höhn, R., Gross, G. M., Gross, M. & Lasanga, L. (1961) A double-blind comparison of placebo and imipramine in the treatment of depressed patients in a state hospital. Journal of Psychiatric Research, 1, 76–91.CrossRefGoogle ScholarPubMed
Holdway, V. (1960) Trial of imipramine. Journal of Mental Science, 106, 1443–6.CrossRefGoogle ScholarPubMed
Hollister, L. E., Overall, J. E., Johnson, M., Pennington, V., Katz, G. & Shelton, J. (1964) Controlled comparison of amitriptyline, imipramine and placebo in hospitalized depressed patients. Journal of Nervous and Mental Diseases, 139, 370–5.CrossRefGoogle ScholarPubMed
Hordern, A. (1966) The anti-depressant drugs. International Journal of Psychiatry, 2, 48–77.Google Scholar
Kenning, I. S., Richardson, N. L. & Tucker, F. G. (1960) The treatment of depressive states with imipramine hydrochloride. Canadian Psychiatric Journal, 5, 60–4.Google Scholar
Kesselman, H. (1962) Prueba de doble control (doubleblind) con imipramina. Acta Psiquiatrica y Psicologica, 8, 334–8.Google Scholar
Kuhn, R. (1957) Uber die Behandlung depressiver Zustände mit einem Iminodibenzylderivat. (G.22355). Schweizerishe Medizinische Wochenschrift, 87, 1135–40.Google Scholar
Lehmann, H. E., Cahn, C. H. & De Verteuil, R. L. (1958) The treatment of depressive conditions with imipramine. (G.22355). Canadian Psychiatric Association Journal, 3, 155–64.Google Scholar
Leyberg, J. T. & Denmark, J. C. (1959) The treatment of depressive states with imipramine hydrochloride (Tofranil). Journal of Mental Science, 105, 1123–6.Google Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. Report to the Medical Research Council by its Clinical Psychiatry Committee. British Medical Journal, i, 881–6.Google Scholar
Miller, A., Baker, E. F. W., Lewis, D. & Jones, A. (1960) Imipramine: a clinical evaluation in a variety of settings. Canadian Psychiatric Association Journal, 5, 150–60.Google Scholar
Overall, J. E., Hollister, L. E., Pokorny, A. D., Casey, J. F. & Katz, G. (1962) Drug therapy in depressions; controlled evaluation of imipramine, isocarboxazid, dextroamphetamine—amobarbital, and placebo. Clinical Pharmacology and Therapeutics, 3, 16–22.CrossRefGoogle ScholarPubMed
Porter, A. M. W. (1970) Depressive illness in a general practice. A demographic study and a controlled trial of imipramine. British Medical Journal, i, 773–8.Google Scholar
Rees, L., Brown, A. C. & Benaim, S. (1961) A controlled trial of imipramine (Tofranil) in the treatment of severe depressive states. Journal of Mental Science, 107, 552–9.Google Scholar
Robin, A. A. & Langley, G. E. (1964) A controlled trial of imipramine. British Journal of Psychiatry, 110, 419–22.Google Scholar
Rothman, T., Grayson, H. & Ferguson, J. (1961) A comparative investigation of isocarboxazid and imipramine in depressive syndromes. Journal of Neuropsychiatry, 2, 158–62.Google ScholarPubMed
Roulet, N., Alvarez, R. R., Duffy, J. P., Lenkoski, L. D. & Bidder, T. G. (1962) Imipramine in depression. A controlled study. American Journal of Psychiatry, 119, 427–31.CrossRefGoogle ScholarPubMed
Schorer, C. E., Lowinger, P. & Dobie, S. (1966) The real effect of imipramine, isocarboxazid and nialamide. Michigan Medicine, 65, 1071–5.Google Scholar
Sloane, R. B., Habib, A. & Batt, U. E. (1959) The use of imipramine (Tofranil) for depressive states in open ward settings of a general hospital. A Preliminary report. Canadian Medical Association Journal, 80, 540–6.Google ScholarPubMed
Wheatley, D. (1967) Influence of doctors' and patients' attitudes in the treatment of neurotic illness. Lancet, ii, 1133–5.CrossRefGoogle ScholarPubMed
Wilson, I. C., Vernon, J. T., Guin, T. & Sandifer, M. G. (1963) A controlled study of treatments of depression. Journal of Neuropsychiatry, 4, 331–7.Google Scholar
Wittenborn, J. R., PLANTE, M., Burgess, F. & MAURER, H. (1962) A comparison of imipramine, electroconvulsive therapy and placebo in the treatment of depressions. Journal of Nervous and Mental Disease, 135, 131–7.CrossRefGoogle ScholarPubMed
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