title: Lithium and desipramine versus desipramine alone in the treatment of severe major depression: a preliminary study.
abstract: Improvement following lithium augmentation is well-documented in depressed patients resistant to tricyclic antidepressants. However, response latency to lithium augmentation is extremely variable, suggesting other mechanisms may be involved. To evaluate whether long-term tricyclic treatment is necessary for lithium augmentation's effect, the rapidity and magnitude of response to lithium combined with desipramine from the start of treatment was compared to desipramine alone in severely depressed patients. Patients with DSM-III-R major depression were randomized to double-blind, placebo-controlled treatment with either lithium + desipramine or placebo + desipramine for 4 weeks. Response criteria were based on Hamilton Depression Rating Scale scores and global improvement. Analysis of covariance of Hamilton scores demonstrated that lithium + desipramine was superior to placebo + desipramine at week 1 (P < 0.009), week 2 (P < 0.028), and week 3 (P < 0.07), although not at week 4. There were more responders to the combination than to monotherapy (P < 0.042). These preliminary data suggest that lithium + desipramine may have some efficacy in severely depressed patients. Further studies with larger samples are needed to confirm these findings.
authors.affiliation: Abraham Ribicoff Research Facilities, Connecticut Mental Health Centre, Department of Psychiatry, Yale University School of Medicine, New Haven, USA.
authors.forename: A
authors.initials: A
authors.lastname: Cappiello
authors.forename: C J
authors.initials: CJ
authors.lastname: McDougle
authors.forename: P L
authors.initials: PL
authors.lastname: Delgado
authors.forename: R T
authors.initials: RT
authors.lastname: Malison
authors.forename: P
authors.initials: P
authors.lastname: Jatlow
authors.forename: D S
authors.initials: DS
authors.lastname: Charney
authors.forename: G R
authors.initials: GR
authors.lastname: Heninger
authors.forename: L H
authors.initials: LH
authors.lastname: Price
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D003891:Desipramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013997:Time Factors
chemical_list: D000929:Antidepressive Agents, Tricyclic; D008094:Lithium; D003891:Desipramine