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The timing, specificity and clinical prediction of tricyclic drug effects in depression

Published online by Cambridge University Press:  09 July 2009

M. M. Katz*
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
S. H. Koslow
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
J. W. Maas
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
A. Frazer
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
C. L. Bowden
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
R. Casper
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
J. Croughan
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
J. Kocsis
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
E. Redmond Jr
Affiliation:
Division of Psychology, Department of Psychiatry, Albert Einstein College of MedicineMontefiore Medical Center, Bronx, NY; Neurosciences Research Branch, National Institute of Mental Health, Rockville, MD; Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX; Department of Psychiatry, University of Pennsylvania, Veterans Administration Hospital, Philadelphia, PA; Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, IL; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Psychiatry, Cornell University Medical College, New York, NY; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
*
* Address for correspondence: Dr Martin M. Katz, Department of Psychiatry, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA

Synopsis

This research was aimed at studying the rate of action of tricyclic drugs in depressive disorders, specifying the behavioural effects associated with recovery, and predicting clinical response. The research design involved comparison of a recovered group with a group treated for the equivalent four weeks, who showed minimal to no response. The findings indicated significant differences in baseline characteristics between responders and non-responders. Further, the drugs were found to act early in the responders, within the first week of treatment. Specific changes at one week which distinguished responder and non-responder groups occurred in the disturbed affects, and in cognitive functioning. Improvements also occurred in somatic symptoms, but these latter changes were general and not associated with later recovery. At 2½ weeks, all facets of the depressed condition showed positive change in the responders. Implications of the results for assessing rate of tricyclic drug actions, their effects on the interaction of affect and neurochemistry, and the practical application of the results for the clinical situation, are discussed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1987

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References

Abou-Saleh, M. T. & Coppen, A. (1983). Classification of depression and response to anti-depressive therapies. British Journal of Psychiatry 143, 601603.CrossRefGoogle Scholar
Cohen, J. (1969). Statistical Power Analysis for the Behavioural Sciences. Academic Press: New York.Google Scholar
Coryell, W., Coppen, A., Zeigler, V. E. & Biggs, J. T. (1982). Early improvement as a predictor of response to amitriptyline and nortriptyline: acomparison of two patient samples. Psychological Medicine 12, 135139.CrossRefGoogle Scholar
Croughan, J., Secunda, S., Koslow, S. H., Maas, J., Katz, M. M., Robins, E. & Davis, J. (1987). Sociodemographic and prior clinical course characteristics as predictors of treatment response. Journal of Psychiatric Research (submitted).Google Scholar
Davis, J. M., Kerman, G. L. & Schildkraut, J. J. (1968). Drugs used in the treatment of depression. In Psychopharmacology: A Review of Progress, 19571969. (ed. Efron, D. H., Cole, J. O., Levine, J. and Wittenborn, J. R.), pp. 718748. GPO: Washington, D.C.Google Scholar
DiMascio, A., Weissman, M. M., Prusoff, B. A., Neu, C., Zwilling, M. & Klerman, G. L. (1979). Differential symptom reduction by drugs and psychotherapy in acute depression. Archives of General Psychiatry 36,14501456.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. K. (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837844.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R. L., Fleiss, J. L. & Cohen, J. (1976). The global assessment scale, a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766771.CrossRefGoogle Scholar
Frazer, A., Lucki, I. & Sills, M. (1985). Alterations in monoaminecontaining neuronal function due to administration of antidepressants repeatedly to rats. Acta Pharmacologica et Toxicologica 56, (Supplement 1), 2134.CrossRefGoogle ScholarPubMed
Glassman, A. H., Kanter, S. J. & Shostak, M. (1975). Depression, delusions, and drug response. American Journal of Psychiatry 132, 716719.Google ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Hollister, L., Overall, J. E., Johnson, M., Pennington, V., Katz, G. & Shelton, J. (1964). Controlled comparison of amitriptyline, imipramine and placebo in hospitalized depressed patients. Journal of Nervous and Mental Diseases 139, 370375.CrossRefGoogle ScholarPubMed
Katz, M. M., Koslow, S. H., Berman, N., Secunda, S., Maas, J. W., Casper, R., Koscis, J. & Stokes, P. (1984). Multivantaged approach to the measurement of behavioural and affect states for clinical and psychological research. Psychological Reports 55, 619671.CrossRefGoogle Scholar
Katz, M. M., Robins, E., Croughan, J., Secunda, S. & Swann, A. (1982). Behavioural measurement and drug response characteristics of unipolar and bipolar depression. Psychological Medicine 12, 2536.CrossRefGoogle ScholarPubMed
Katz, M. M., Secunda, S. K., Hirschfeld, R. M. A. & Koslow, S. H. (1979). NIMH-Clinical Research Branch Collaborative Program on the Psychobiology of Depression. Archives of General Psychiatry 34, 765771.CrossRefGoogle Scholar
Kessler, K. A. (1978). Tricyclic anti-depressants: mode of action and clinical use. In Psychopharmacology: A Generation of Progress. (ed. Lipton, M. A., DiMascio, A. and Killam, K. F.), pp. 12891302. Raven Press: New York.Google Scholar
Klerman, G. L. & Cole, J. O. (1965). Clinical pharmacology of imipramine and related anti-depressant compounds. Pharmacological Reviews 17, 101141.Google Scholar
Maas, J. W., Koslow, S. H., Davis, J., Katz, M. M., Mendels, J., Robins, E., Stokes, P. & Bowden, C. (1980). Biological component of the NIMH Clinical Research Branch Collaborative Program on the Psychobiology of Depression: I. background and theoretical considerations. Psychological Medicine 10, 759776.CrossRefGoogle ScholarPubMed
Medical Research Council, (1965). Clinical trial of the treatment of depressive illness. British Medical Journal i, 881886.Google Scholar
Morrison, D. F. (1967). Multivariate Statistical Methods. McGraw-Hill: New York.Google Scholar
Quitkin, F. M., Rabkin, J. G., Ross, D. & McGrath, P. J. (1984). Duration of anti-depressant drug treatment. Archives of General Psychiatry 41, 238245.CrossRefGoogle Scholar
Secunda, S., Koslow, S. H., Redmond, D. E., Garver, D., Ramsey, T. A., Croughan, J., Koscis, J., Hanin, I. & Lieberman, K. (1980). Biological component of the NIMH Clinical Research Branch Collaborative Program on the Psychobiology of Depression: II.methodology and data analysis. Psychological Medicine 10,777793.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, R. (1978). Research diagnostic criteria. Archives of General Psychiatry 35, 713782.CrossRefGoogle ScholarPubMed
Sugrue, M. F. (1983). Chronic antidepressant therapy and associated changesin central monoaminergic receptor functioning. Pharmacology and Therapeutics 21, 133.CrossRefGoogle Scholar
Wittenborn, J. R. (1966). The assessment of clinical change. In Pharmacotherapy of Depression. (ed. Cole, J. O. and Wittenborn, J. R.), pp. 6790. Charles C. Thomas: Springfield, Ill., USA.Google Scholar