The pharmacological treatment of delusional depression: Part II.
This study investigated the pharmacological treatment of delusional depressives by assigning patients on a random double-blind basis to amitriptyline (AT) alone, perphenazine (PER) alone, or AT + PER. As reported in an earlier paper, the combination of AT + PER was the superior treatment with a response rate of 78% compared with 41% for AT alone and 19% for PER alone. This difference is both clinically and statistically significant (p less than 0.01). In this second article, the authors report that the patients on AT + PER had higher plasma levels of AT and its pharmacologically active metabolite nortriptyline (NT) than the patients on AT alone. Although the response rate had a direct relationship to AT + NT plasma levels, an analysis of variance showed that the group of patients treated with AT + PER still had a significantly higher response rate, even after controlling for the plasma levels of AT + NT (p less than 0.05). There was also a correlation between PER plasma levels and clinical response.
D000639:Amitriptyline / Q000097:blood / Q000627:therapeutic use*; D003702:Delusions / Q000097:blood / Q000188:drug therapy*; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D009661:Nortriptyline / Q000097:blood; D010546:Perphenazine / Q000097:blood / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D011897:Random Allocation
D000639:Amitriptyline; D009661:Nortriptyline; D010546:Perphenazine