Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-04T13:36:29.640Z Has data issue: false hasContentIssue false

Clomipramine, Tryptophan and Lithium in Combination for Resistant Endogenous Depression: Seven Case Studies

Published online by Cambridge University Press:  02 January 2018

A. S. Hale*
Affiliation:
Geoffrey Knight Unit for Affective Disorders, Brook General Hospital, and the United Medical and Dental Schools, Guy's Hospital
A. W. Procter
Affiliation:
United Medical and Dental Schools, Guy's Hospital
P. K. Bridges
Affiliation:
Geoffrey Knight Unit for Affective Disorders, and United Medical and Dental Schools, Guy's Hospital
*
Guy's Hospital, London Bridge, London SE1 9RT

Extract

Seven patients suffering from severe endogenous depression who had proven resistant to lengthy trials of treatment with tricyclic and other antidepressants are described. Their successful treatment with a combination of clomipramine, L-tryptophan and lithium is discussed in the context of other strategies for the treatment of resistant depression.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1987 

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

Ayd, F. J. Jr. (1966) Combining the antidepressant drugs. International Drug and Therapeutics Newsletter, 1, 13.Google Scholar
Barker, W. A. & Eccleston, D. (1984) The treatment of chronic depression: an illustrative case. British Journal of Psychiatry, 144, 317319.Google Scholar
Brewerton, T. D. & Reus, V. I. (1983) Lithium carbonate and L-tryptophan in the treatment of bipolar and schizoaffective disorders. American Journal of Psychiatry, 140, 757760.Google ScholarPubMed
Bridges, P. K. (1983) ‘… and a small dose of an antidepressant might help’ British Journal of Psychiatry, 142, 626629.Google Scholar
Burns, D. D. & Mendels, J. (1979) Serotonin and affective disorders. Current Developments in Psychopharmacology, 5, 293359.Google Scholar
Chouinard, G., Jones, B. D., Young, S. N. & Annable, L. (1979) Potentiation of lithium by tryptophan in a patient with bipolar illness. American Journal of Psychiatry, 136, 719720.Google Scholar
Davidson, J., Mcleod, M., Law-Yone, B. & Linnoila, M. (1978) Comparison of electroconvulsive therapy and combined phenelzine-amitriptyline in refractory depression. Archives of General Psychiatry, 35, 639642.CrossRefGoogle ScholarPubMed
D'elia, G., Hanson, L. & Raotma, H. (1978) L-tryptophan and 5-hydroxytryptophan in the treatment of depression: a review. Acta Psychiatrica Scandinavia, 57, 239252.Google Scholar
De Montigny, C., Cournoyer, G., Morissette, R., Langois, R. & Caille, G. (1983) Lithium carbonate addition in tricyclic antidepressant-resistant unipolar depression. Archives of General Psychiatry, 40, 13271334.CrossRefGoogle ScholarPubMed
Eccleston, D. (1981) Monoamines in affective illness. Is there a place for 5HT? British Journal of Psychiatry, 138, 257258.Google Scholar
Goldberg, R. S. & Thornton, W. E. (1978) Combined tricyclic-MAOI therapy for refractory depression: a review, with guidelines for appropriate usage. Journal of Clinical Pharmacology, 18, 143147.CrossRefGoogle ScholarPubMed
Heninger, G. R., Charney, D. S. & Sternberg, D. E. (1983) Lithium carbonate augmentation of antidepressant treatment: an effective prescription for the treatment of refractory depression. Archives of General Psychiatry, 40, 13351342.CrossRefGoogle ScholarPubMed
Klein, D. F. & Davis, J. M. (1969) Diagnosis and Drug Treatment in Psychiatric Disorders. Baltimore: Williams and Wilkins.Google Scholar
Kotin, J., Post, R. M. & Goodwin, F. K. (1973) Drug treatment of depressed patients referred for hospitalization. American Journal of Psychiatry, 130, 11391141.CrossRefGoogle ScholarPubMed
Lingjaerd, O., Edlund, A. H. & Gormsen, C. A. (1974) The effect of lithium carbonate in combination with tricyclic antidepressants in endogenous depression. Acta Psychiatrica Scandinavica, 50, 233242.Google Scholar
Nelson, J. C. Jatlow, P., Quinlan, D. M. & Bowers, M. B. (1982) Desipramine plasma concentration and antidepressant response. Archives of General Psychiatry, 39, 14191422.Google Scholar
Paykel, E. S. (1979) Predictors of treatment response. In Psychopharmacology of affective disorders (eds Paykel, E. S. & Coppen, A.). Oxford: Oxford University Press.Google Scholar
Paykel, E. S. & Hale, A. S. (1986) Recent advances in the treatment of depression. In The Biology of Depression (ed. Deakin, J. F.). London: Gaskell (Royal College of Psychiatrists).Google Scholar
Price, L. H., Charney, D. S. & Heninger, G. R. (1985) Efficacy of lithium-tranylcypromine treatment in refractory depression. American Journal of Psychiatry, 142, 619623.Google ScholarPubMed
Quitkin, F. M. (1985) The importance of dosage in prescribing antidepressants. British Journal of Psychiatry, 147, 593597.Google Scholar
Quitkin, F. M. Rifkin, A. & Klein, D. F. (1979) Monoamine oxidase inhibitors: review of antidepressant effectiveness. Archives of General Psychiatry, 36, 749760.CrossRefGoogle ScholarPubMed
Quitkin, F. M. Rabkin, J. G., Ross, D. & Mcgrath, P. J. (1984) Duration of antidepressant drug treatment. What is an adequate trial? Archives of General Psychiatry, 41, 238245.CrossRefGoogle ScholarPubMed
Razani, J., White, K., White, J., Simpson, G., Sloane, R. B., Rebal, R. & Palmer, R. (1983) The safety and efficacy of combined amitriptyline and tranylcypramine antidepressant treatment. Archives of General Psychiatry, 40, 657661.Google Scholar
Sargant, W. (1963) Combining the antidepressant drugs. The Lancet, ii, 634635.CrossRefGoogle Scholar
Schatzberg, A. F., Cole, J. O., Cohen, B. M. (1983) Survey of depressed patients who failed to respond to treatment. In The Affective Disorders (eds Davis, J. M. & Maas, J. W.). Washington DC: American Psychiatric Press.Google Scholar
Schrader, G. D. & Levien, H. E. M. (1985) Response to sequential administration of clomipramine and lithium carbonate in treatment resistant depression. British Journal of Psychiatry, 147, 573575.Google Scholar
Schuckit, N. A. & Feighner, J. D. (1972) Safety of high dose tricyclic antidepressant therapy. American Journal of Psychiatry, 128, 14561459.CrossRefGoogle ScholarPubMed
Sethna, E. (1974) A study of refractory cases of depressive illness and their response to combined antidepressant treatment. British Journal of Psychiatry, 124, 265272.CrossRefGoogle Scholar
Shaw, D. M., Mcsweeney, D. A., Hewland, R. & Johnson, A. L. (1975) Tricyclic antidepressants and tryptophan in unipolar affective disorder. Psychological Medicine, 5, 276278.Google Scholar
Shaw, D. M. (1983) Resistant depression. In Affective Disorders-Latest Developments . Proceedings of the Boots Company Symposia. Nottingham: Boots.Google Scholar
Thompson, J., Rankin, H., Ashcroft, G. W., Yates, G. M., Mcqueen, J. K. & Cummings, S. W. (1982) The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline and a combination of L-tryptophan with placebo. Psychological Medicine, 12, 741751.Google Scholar
Tissot, R. & Shafner, H. (1980) Amino-acid precursors of monoamines in the treatment of depression. In New advances in the diagnosis and treatment of depressive illness (ed. Mendlewicz, J.). Amsterdam: Excerpta Medica.Google Scholar
White, K., Pistole, T. & Boyd, J. L. (1980) Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: pilot study. American Journal of Psychiatry, 137, 14221425.Google Scholar
Worrall, E. F., Moody, J. P., Peet, M., Dick, P. Smith, A., Chambers, C., Adams, M. & Naylor, G. J. (1979) Controlled studies in the acute antidepressant effect of lithium. British Journal of Psychiatry, 135, 225262.CrossRefGoogle ScholarPubMed
Young, J. P. R., Lader, M. H. & Hughes, W. C. (1979) Controlled trial in trimipramine, monoamine oxidase inhibitors and combined treatment in depressed out-patients. British Medical Journal, ii, 13151317.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.