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Imipramine treatment for chronic depression.

Abstract
Antidepressant drugs in the treatment of chronic depressions have received little systematic study. We used a two-week, single-blind placebo washout followed by a six-week, double-blind comparison of imipramine hydrochloride and placebo in a sample of 76 outpatients with DSM-III dysthymic disorder entered into a trial at two centers. Subjects were preponderantly female, had insidious onset at an early age, and had depressions of moderate severity; 96% also met the DSM-III criteria for major depressive disorder at the time of presentation. Sixty percent had a history of persistent depressive symptoms sufficient to meet criteria for major depression for longer than two years. Markedly favorable responses occurred in 45% of imipramine-treated (n = 29) and 12% of placebo-treated (n = 25) patients and, respectively, 59% and 13% of those who completed the study. Imipramine produced significant advantage in measures of depressive symptoms, global severity of illness, and self-rated social and vocational function. Recovered patients experienced remission from both long-standing symptoms and deficits as well as more recently exacerbated aspects of their syndrome. Patients with pure dysthymic disorder of a mild, subsyndromal type were uncommon in these clinical settings. However, anti-depressant medication was effective for many moderately severe chronic depressions, which had previously been untreated or undertreated, presumably related to misdiagnosis.
AuthorsJ H Kocsis, A J Frances, C Voss, J J Mann, B J Mason, J Sweeney
JournalArchives of general psychiatry (Arch Gen Psychiatry) Vol. 45 Issue 3 Pg. 253-7 (Mar 1988) ISSN: 0003-990X [Print] UNITED STATES
PMID3277579 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Imipramine
Topics
  • Adult
  • Ambulatory Care
  • Chronic Disease
  • Clinical Trials as Topic
  • Depressive Disorder (drug therapy, psychology)
  • Double-Blind Method
  • Female
  • Health Status
  • Humans
  • Imipramine (therapeutic use)
  • Male
  • Outcome and Process Assessment (Health Care)
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Social Adjustment

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