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Imipramine treatment for chronic depression.

J H Kocsis1, A J Frances, C Voss

  • 1Department of Psychiatry, New York Hospital-Cornell Medical Center, NY 10021.

Archives of General Psychiatry
|March 1, 1988
PubMed
Summary

Imipramine hydrochloride, an antidepressant, effectively treated chronic depressions in a double-blind study. This medication improved symptoms and functioning in patients with dysthymic disorder, including those with major depressive disorder.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • Chronic depressions, including dysthymic disorder, have historically received limited systematic study regarding antidepressant efficacy.
  • Many patients with dysthymic disorder also present with comorbid major depressive disorder, complicating treatment approaches.
  • Understanding the effectiveness of antidepressant medications in long-term depressive conditions is crucial for clinical practice.

Purpose of the Study:

  • To systematically evaluate the efficacy of imipramine hydrochloride compared to placebo in treating outpatients with DSM-III dysthymic disorder.
  • To assess the impact of imipramine on depressive symptoms, overall illness severity, and psychosocial functioning.
  • To characterize the patient population with chronic depression in a clinical trial setting.

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Main Methods:

  • A two-week single-blind placebo washout was followed by a six-week double-blind comparison of imipramine hydrochloride and placebo.
  • The study included 76 outpatients diagnosed with DSM-III dysthymic disorder across two clinical centers.
  • Outcome measures included depressive symptom ratings, global illness severity, and self-rated social and vocational function.

Main Results:

  • A markedly favorable response was observed in 45% of patients treated with imipramine compared to 12% on placebo.
  • Imipramine demonstrated significant advantages in reducing depressive symptoms and global severity of illness.
  • Patients receiving imipramine showed improved self-rated social and vocational functioning compared to the placebo group.

Conclusions:

  • Imipramine hydrochloride is an effective treatment for moderately severe chronic depressions, particularly when patients also meet criteria for major depressive disorder.
  • The study highlights the effectiveness of antidepressant medication in conditions previously undertreated, potentially due to misdiagnosis.
  • Recovered patients experienced remission of both long-standing and acute depressive symptoms, underscoring the medication's broad impact.