HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Azima, H. Search for Related Content PubMed PubMed Citation Articles by Azima, H.

Psychodynamic and Psychotherapeutic Problems in Connection with Imipramine (Tofranil) Intake^*

Mcgill University and Allen Memorial Institute, Montreal

^* Presented partly at New York Divisional Meeting of A.P.A., November, 1959.

ABSTRACT

The effect of imipramine on depressive states was presented and a hierarchical methodology outlined, where the drug action was studied at three levels: phenomenological, psychodynamic and psychotherapeutic. From a psychodynamic point of view the following events seem to occur concomitant with imipramine: (1) A change in the mood of depression either to the pre-morbid state, or towards elation and mania. (2) A decrease in guilt feelings and a change from an undue preoccupation with internal object relations to external object relations. (3) A primary change in the direction of aggressive tendencies from inward to outward. (4) Secondary reorganization of libidinal tendencies.

The mode of action of imipramine could be conceptualized as the induction of an economic shift in the aggressive cathecting energies of internalized systems of control (super-ego components) resulting in a primary reorganization of aggressive object relations, a secondary reorganization of libidinal object relations, and subsequent relief of depressive state.

Based upon the above conclusions the drug was given to 5 not overtly depressed patients on a predictive level and the following conclusions reached: (1) Imipramine is useful in the initial stages of psychoanalysis of severe depressions; (2) it is useful in depressive episodes occurring during psychoanalysis; and (3) it may be used beneficially in "latent depressions" where intense guilt feelings prevent the setting in of psychoanalytic processes.