CONTROLLED COMPARISON OF AMITRIPTYLINE, IMIPRAMINE AND PLACEBO IN HOSPITALIZED DEPRESSED PATIENTS

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Abstract
Two anti-depressant drugs, imipramine and amitriptyline, were compared with an atropine control in 93 men hospitalized with depressive reactions. Treatment was continued for three weeks, doses of imipramine averaging 171 mg. and amitriptyline 157 mg during the last 2 weeks. Two rating scales, from which 7 factors relevant to depression were derived, were used for evaluating change. Each treatment group tended to show rapid improvement during treatment, all 7 factors being favorably affected by at least 1 treatment; both drugs improved scores on 5 factors and the control treatment on three. Although each drug was superior to the control treatment in some respect, most differences were small and inconsistent between the drugs. Only on 1 factor, related to psychotic thinking, were both drugs clearly superior to the control treatment, suggesting their applicability in depressions complicated by psychosis. Amitriptyline was superior to imipramine in improving a measure concerned with guilt feelings especially if this symptom was initially severe; this was the only instance of a significant difference between the drugs when compared with each other. Amitri-ptyline also produced more improvement in a comprehensive measure of depression among patients ranked initially as severely depressed. Side-effects were mainly of the anticholinergic type, resembling those from atropine but being somewhat more frequent with the doses of drugs used.

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