Rapid Achievement of Antidepressant Effect with Intravenous Chlorimipramine

Publisher Website
Google Scholar
Abstract
To the Editor: Among the perplexing issues in the treatment of major depression is the fact that patients frequently require three or more weeks of treatment with substantial doses of tricyclic antidepressants before any marked therapeutic change is manifest.1 The lag in response may be due to an equilibration delay between optimal drug concentrations and the site producing the clinical response, a phenomenon known as "anticlockwise hysteresis."2 Other possibilities include changes in receptor sensitivity that appear to be dependent on time rather than necessarily produced by continuous treatment.3 , 4 The variable, extensive, hepatic presystemic clearance and the long half-lives of these . . .