Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-26T06:31:58.379Z Has data issue: false hasContentIssue false
  • English
  • Français

A Comparative Trial of Imipramine and Chlorpromazine in Depressed Patients

Published online by Cambridge University Press:  29 January 2018

E. S. Paykel ,
J. S. Price ,
R. U. Gillan ,
G. Palmai  and
E. S. Chesser
E. S. Paykel
Affiliation:
Department of Psychiatry, Tale University School of Medicine, 34 Park Street, New Haven, Connecticut, 06519, U.S.A
J. S. Price
Affiliation:
Psychiatric Genetics Research Unit, Institute of Psychiatry, Maudsley Hospital, Denmark Hill, London, S.E.5
R. U. Gillan
Affiliation:
Runwell Hospital, nr. Wickford, Essex
G. Palmai
Affiliation:
University of Leeds School of Medicine, 15 Hyde Terrace, Leeds, 2
E. S. Chesser
Affiliation:
The Academic Department of Psychiatry, Middlesex Hospital Medical School, London, W.1
Get access Rights & Permissions [Opens in a new window]

Extract

The majority of controlled trials of imipramine against placebo in the treatment of depression have indicated the general efficacy of the drug (9). Recently there has been renewed interest in the use of the phenothiazines in depression, and the question has been raised as to how far the actions of the imipramine-like drugs and of the phenothiazines can be differentiated. Structurally, the iminodibenzyl nucleus of imipramine closely resembles the phenothiazine nucleus, the only difference being replacement of the sulphur atom bridging the two benzyl rings in the latter by a CH2–CH2 group in the iminodibenzyl nucleus. Two controlled trials have suggested that in depressed patients the phenothiazines may be more valuable than has been previously realized and similar in overall efficacy to imipramine. Fink et al. (3) found both chlorpromazine and imipramine significantly better than placebo in the treatment of depressives, with only minor and insignificant differences between them. Similarly, in a relatively large collaborative trial, Overall et al. (11) found thioridazine as effective as imipramine. These authors subsequently employed a special statistical classification technique to stratify their patients into three subtypes according to initial symptom profiles (8). With respect to a variety of symptom ratings, this stratification revealed significant differences in drug effects. Imipramine proved superior in “retarded” depressives and thioridazine in “anxious” depressives, while no differences were found in “hostile” depressives.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 114 , Issue 515 , October 1968 , pp. 1281 - 1287
Copyright
Copyright © Royal College of Psychiatrists, 1968 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Dengler, J. J., and Trrus, E. O. (1961). “The effect of drugs on the uptake of isotopic norepinephrine in various tissues.” Biochem. Pharmacol., 8, 64.Google Scholar
2. Fink, M., Pollack, M., Klein, D. F., Blumberg, A. G., Belmont, I., Karp, E., Kramer, J. D., and Willner, A. (1964). “Comparative studies of chlorpromazine and imipramine.” In: Neuropsychopharmacology (eds. Bradley, P. B., Fluegel, F., and Hoch, P. H.). Amsterdam, 3, 370–372.Google Scholar
3. Fink, M., Klein, D. F., and Kramer, J. C. (1965). “Clinical efficacy of chlorpromazine-procyclidine combinations, imipramine and placebo in depressive disorders.” Psychopharmacologia (Berlin), 5, 27–36.Google Scholar
4. Glowinski, J., and Axelrod, J. (1964). “Inhibition of uptake of tritiated-noradrenaline in the intact rat brain by imipramine and structurally related compounds.” Nature, 204, 1318–1319.Google Scholar
5. Halliwell, G., Quinton, R. M., and Williams, F. E. (1964). “A comparison of imipramine, chlorpromazine and related drugs in various tests involving autonomic functions and antagonism of reserpine.” Brit. J. Pharmacol., 23, 330–350.Google Scholar
6. Hamilton, M. (1960). “A rating scale for depression.” J. Neurol. Neurosurg. Psychiat., 23, 56–62.Google Scholar
7. Herr, F., Stewart, J., and Charest, M. P. (1961). “Tranquilizers and antidepressants: a pharmacological comparison.” Arch, intern. Pharmacodyn., 134, 328–342.Google Scholar
8. Hollister, L. E., and Overall, J. E. (1965). “Reflections on the specificity of action of antidepressants.” Psychosomatics, 6, 361–365.Google Scholar
9. Klerman, G. L., and Cole, J. O. (1965). “Clinical pharmacology of imipramine and related antidepressant compounds.” Pharmacol. Rev., 17, 101–141.Google Scholar
10. Overall, J. E., Hollister, L. E., Pokorny, A. D., Casey, J. F., and Katz, G. (1962). “Drug therapy in depressions. Controlled evaluation of imipramine, isocarboxazide, dextro-amphetamine-amobarbitol, and placebo.” Clin. Pharmacol. Ther., 3, 16–22.Google Scholar
11. Overall, J. E., Meyer, F., Kimbell, I. Jr., and Shelton, J. (1964). “Imipramine and thioridazine in depressed and schizophrenic patients. Are there specific antidepressant drugs?” J. Amer. med. Ass., 189, 605–608.Google Scholar
12. Paykel, E. S., Price, J. S., Gillan, R. U., Palmai, G., and Chesser, E. S. (1968). “Imipramine and chlorpromazine: a comparative trial of their effects on the symptomatology of affective illnesses.” Proc. IVth World Congress of Psychiatry, ig66, Madrid. (In press.)Google Scholar
13. Pollack, M., Klein, D. F., Willner, A., Blumberg, A. G., and Fink, M. (1965). “Imipramine-induced behavioural disorganization in schizophrenic patients: physiologic and psychologic correlates.” In: Recent Advances in Biological Psychiatry (ed. Wortis, J.). New York, 7, 53–61.Google Scholar
14. Robin, A. A., and Langley, G. E. (1964). “Controlled trial of imipramine.” Brit. J. Psychiat., 110, 419–422.Google Scholar
15. Stein, L. (1962). “Effects and interactions of imipramine, chlorpromazine, reserpine, and amphetamine on self-stimulation: possible neuro-physiological basis of depression.” In: Recent Advances in Biological Psychiatry (ed. Wortis, J.). New York, 4, 288–309.Google Scholar
16. Sulser, F., Watts, J., and Brodie, B. B. (1962). “On the mechanism of antidepressant action of imipramine-like drugs.” Ann. N.T. Acad. Sci., 96, 279–286.Google Scholar
17. Sulser, F., Watts, J., and Dingell, J. V. (1966). “On the role of adrenergic mechanisms in the mode of action of tricyclic antidepressants (Biochemical and metabolic considerations).” In: Antidepressant Drugs of Non-MAO Inhibitor Type. Proceedings of a Workshop (eds. Efron, D. H. and Kety, S. S.). Washington D.C., 1–40.Google Scholar
18. Uhlenhuth, E. H., and Park, L. C. (1964). “The influence of medication (imipramine) and doctor in relieving depressed psychoneurotic outpatients.” J. psychiat. Res., 2, 101–122.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.