A comparative trial of Anafranil, Pertofran and an Anafranil/Pertofran combination

On the grounds of different pharmacological properties and possibly different clinical effects, two antidepressants, Anafranil (clomipramine) and Pertofran (desipramine) were compared in the management of depression in general practice. A further comparison was made to ascertain whether a combination of the two antidepressants was more effective than the drugs given alone. One hundred and seventy-three patients were admitted to a double-blind clinical trial, conducted on a multicentre basis in general practice, in which a double-dummy technique was employed. One hundred and forty-one patients completed the study. Of these, 49 received Anafranil, 49 received Pertofran and 43 the combination. Although there were no statistically significant differences between the three treatment regimes, there was a consistent trend in favour of the combination regime. Ninety-one per cent of the patients who completed treatment on the combination showed satisfactory improvement compared with 81% on the Anafranil regime and 78% on Pertofran. An attempt was made to identify three symptom clusters--anxiety, 'anergia' and biological depression. There was no significant difference in the response of these three clusters to the three treatment regimes, nor was there any difference in the incidence and severity of side-effects.