Psychological Medicine

Research Article

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

M. M. Katza1 c1, S. H. Koslowa1, J. W. Maasa1, A. Frazera1, C. L. Bowdena1, R. Caspera1, J. Croughana1, J. Kocsisa1 and E. Redmond Jra1

a1 Division of Psychology, Department of Psychiatry, Albert Einstein College of Medicine Montefiore 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.

Abstract

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.

Correspondence:

c1 Address for correspondence: Dr Martin M. Katz, Department of Psychiatry, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA

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