A Double-Blind Trial of Phenelzine and Amitriptyline in Depressed Out-Patients. a Possible Differential Effect of the Drugs on Symptoms

The question of whether MAO inhibitors were most useful in atypical depressions, with tension and anxiety, but were ineffective in patients with inadequate personalities is reexamine in a double-blind trial of phenelzine and amitriptyline in depressed out-patients.

Abstract

It is widely agreed that the MAO inhibitor group of drugs are less effective anti-depressants than the tricyclics in severe depressions, specially those of endogenous type (Medical Research Council, 1965), but a role for them is still claimed, for example, in the treatment of milder depressions or of depressive symptoms. According to Pöldinger (1967) they are ‘thermagasics', i.e. psychic energizers or disinhibitors, and their mood elevating effect is relatively slight. Dally (1965) maintained that MAO inhibitors were most useful in atypical depressions, with tension and anxiety, but were ineffective in patients with inadequate personalities. Kelly et al. (1970) found that these drugs relieved depressive symptoms in phobic anxiety states. In this paper we have attempted to reexamine this question in a double-blind trial of phenelzine and amitriptyline in depressed out-patients.