A COMPARISON OF IMIPRAMINE, ELECTROCONVULSIVE THERAPY AND PLACEBO IN THE TREATMENT OF DEPRESSIONS

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Abstract
The patients were women under 45 years of age and newly admitted to a New Jersey State hospital. None of the patients appeared to be suffering from a schizophrenic process, and none were addicted to alcohol. Dosage level was determined by the physician in charge of the patient and did not exceed 200 mg per day. The placebo was indistinguishable from imipramine. This phase of the investigation was conducted in a double-blind manner. The assignment of the patients to the treatment groups was predetermined on a random basis. The patients were observed intensively, tested, and rated before being assigned to a treatment, and this evaluation was repeated when the patient was ready to go home or at the end of a maximal period of 10 weeks. The tests and ratings represented criteria for the major characteristics of a depressive disorder. Using analysis of covariance, the investigators found an adjusted posttreatment mean for each of the treatment groups separately; comparison of these means revealed the relative efficacy of the treatments. It was found that the imipramine group was superior to the placebo group with respect to the symptoms of anxiety and depression, with respect to subjective depression as revealed by the MMPI and with respect to the "friendly" score on the Clyde Mood Scale. The imipramine group showed a much shorter latency than the ECT group on the Standard Interview. The ECT group was superior to the placebo group with respect to the subjective aspects of depression as measured by the psychasthenia and depression scores on the MMPI, and the "friendly" score on the Clyde Mood Scale. Imipramine may be more generally efficacious than ECT in the sense that its ameliorating effects appear to influence more aspects of behavior than does ECT.

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