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REM Sleep Reduction Effects on Depression Syndromes

REM Sleep Reduction Effects on Depression Syndromes Abstract Thirty-four endogenous and 18 reactive, depressed patients (hospitalized and nonschizophrenic) were treated in a double-blind, crossover study of the hypothesis that rapid eye movement (REM) sleep reduction (by awakenings) relieves depression. In the endogenous group—but not in the reactive group—subjects deprived of REM sleep for three weeks improved significantly more than control subjects awakened from non-REM sleep. Therapeutic efficacy of REM sleep reduction appeared similar to reported efficacy of imipramine hydrochloride treatment of depression. Eight of nine endogenous patients, unimproved by REM sleep deprivation, did not improve with imipramine. Results suggested (1) that substantial REM sleep reduction has antidepressant activity, and (2) since imipramine and other drug antidepressants reduce REM sleep much more so than nonantidepressant drugs, that an antidepressant "mechanism" of drugs resides in their capacity to substantially reduce REM sleep. References 1. 29,32,34,38-44,46,48,50-86. 2. 40,71,75,77,78,80,82,84-86. 3. 29,32,34,41,42,46,48,61,66,67,69,70. 4. Dement WC: The effect of dream deprivation . Science 131:1705-1707, 1960.Crossref 5. Dement WC, Fisher C: Experimental interference with the sleep cycle . Can Psychiatr Assoc J 8:400-405, 1963. 6. Vogel GW: REM deprivation: III. Dreaming and psychosis . Arch Gen Psychiatry 18:312-329, 1968.Crossref 7. Vogel GW, Traub AC: REM deprivation: I. The effect on schizophrenic patients . Arch Gen Psychiatry 18:287-300, 1968.Crossref 8. Vogel GW, Traub AC: The effects of REM deprivation on psychotically depressed patients . Psychophysiol 4:382, 1968. 9. Vogel GW, Traub AC: Further studies on REM deprivation of depressed patients . Psychophysiol 5:239, 1968. 10. Vogel GW, Traub AC, Ben-Horin P, et al: REM deprivation: II. The effects on depressed patients . Arch Gen Psychiatry 18:301-311, 1968.Crossref 11. Hishikawa Y, Nakai K, Ida H, et al: The effect of imipramine, desmethylimipramine and chloropromazine on the sleepwakefulness cycle of the cat . Electroencephalogr Clin Neurophysiol 19:518-521, 1965.Crossref 12. Ryba P, Engelwardt DM, Dreedman W, et al: Effects of imipramine on sleep patterns of psychiatric patients. Read before the Association for the Psychophysiological Study for Sleep, Gainesville, Fla, 1966. 13. Hartmann E: Pharmacological studies in man: Phenobarbital (Nembutal), amitryptyline (Elavil), chlordiazepoxide (Librium), and Ro5-6901 (Dalmane) . Psychophysiol 4:391, 1968. 14. Le Gassicke J, Ashcroft GW, Eccleston D, et al: The clinical state, sleep and amine metabolism of a tranylcypromine (parnate) addict . Br J Psychiatry 111:357-364, 1965.Crossref 15. Jouvet M: Mechanisms of the states of sleep: A neuropharmacological approach , in Kety SS, Evarts FV, Williams HL (eds): Sleep and Altered States of Consciousness . Baltimore, Williams & Wilkins Co, 1967, pp 86-126. 16. Cohen H, Dement WC, Duncan R: The effect of electroconvulsive shock on REM sleep deprivation in the cat. Read before the Association for the Psychophysiological Study for Sleep, Gainesville, Fla, 1966. 17. Cohen H, Dement WC: Suppression of rapid eye movement sleep in following electroconvulsive shock. Read before the APSS, Gainesville, Fla, 1966. 18. Zarcone J, Gulevich G, Dement W: Some relationships between REM sleep and electrically induced convulsions. Read before the APSS, Gainesville, Fla, 1966. 19. Hartmann E: Reserpine: Its effect on the sleep-dream cycle in man . Psychopharmacol 9:246-247, 1966.Crossref 20. Dement WC: Recent studies on the biological role of REM sleep . Am J Psychiatry 122:404-408, 1965. 21. Vogel GW, Thompson FC Jr, Boatwright MH: The effect of REM deprivation on depression, abstracted . Psychophysiol 9:138, 1972. 22. Vogel GW, Thompson FC, Thurmond A, et al: The effect of REM deprivation on depressive syndromes , in Chase MH, Stern WC, Walter PL (eds): Sleep Research . Los Angeles, Brain Information Service, Brain Research Institute, University of California, 1972, vol 1, p 167. 23. Vogel GW, Thompson FC, Thurmond A, et al: The effect of REM deprivation on depression . Psychosomatics 14:104-107, 1973.Crossref 24. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 23:56-62, 1960.Crossref 25. Kiloh LG, Garside RF: The independence of neurotic depression and endogenous depression . Br J Psychiatry 109:451-463, 1963.Crossref 26. Rosenthal SH, Klerman GL: Content and consistency in the endogenous depressive pattern . Br J Psychiatry 122:471-484, 1966.Crossref 27. Mendels J, Cochrane C: The nosology of depression: The endogenous-reactive concept . Am J Psychiatry 124 ( (suppl) ):1-11, 1968. 28. Rechtschaffen A, Kales A (eds): A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects . National Institutes of Health, Neurological Information Network, Bethesda, Md, 1968. 29. Zung WWK: A self-rating depression scale . Arch Gen Psychiatry 12:63-70, 1965.Crossref 30. Wechsler D: Wechsler Adult Intelligence Scale . New York, The Psychological Corp, 1955. 31. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co Inc, 1956. 32. Clinical Psychiatry Committee of the British Medical Research Council: Clinical trial of the treatment of depressive illness . Br Med J 1:881-886, 1965.Crossref 33. Prusoff BA, Klerman GL, Paykel ES: Concordance between clinical assessments and patients' self-report in depression . Arch Gen Psychiatry 26:546-552, 1972.Crossref 34. Carroll BJ, Fielding JM, Blashki TG: Depression rating scales . Arch Gen Psychiatry 28:361-366, 1973.Crossref 35. Overall JE, Hollister LE, Porkorny AD, et al: Drug therapy in depression, controlled evaluation of imipramine, isocarboxazid, dextroamphetamine—amobarbital and placebo . Clin Pharmacol Ther 3:16-22, 1962. 36. Friedman AS: Minimal effects of severe depression on cognitive functioning . J Abnorm Soc Psychol 69:237-243, 1964.Crossref 37. Kenning IS, Richardson NL, Tucker FG: The treatment of depressive states with imipramine hydrochloride . Can Psychiatr Assoc J 5:60-64, 1960. 38. Akindele MO, Evans JI, Oswald I: Monoamine oxidase inhibitors, sleep and mood . Electroencephalogr Clin Neurophysiol 29:47-56, 1970.Crossref 39. Wyatt RJ, Fram DH, Kupfer DJ, et al: Total prolonged drug-induced REM sleep suppression in anxious-depressed patients . Arch Gen Psychiatry 24:145-155, 1971.Crossref 40. Dunleavy DLF, Oswald I: Phenelzine, mood response, and sleep . Arch Gen Psychiatry 28:353-356, 1973.Crossref 41. Wittenborn JR, Plante M, Burgess F, et al: A comparison of imipramine, electroconvulsive therapy and placebo in the treatment of depressions . J Nerv Ment Dis 135:131-137, 1962.Crossref 42. Ball JRB, Kiloh LG: A controlled trial of imipramine in treatment of depressive states . Br Med J 2:1052-1055, 1959.Crossref 43. Greenblatt M, Grosser GH, Wechsler H: Differential response of hospitalized depressed patients to somatic therapy . Am J Psychiatry 120:935-943, 1964. 44. Raskin A, Schulterbrandt JG, Reatig N, et al: Differential response to chlorpromazine, imipramine, and placebo: A study of subgroups of hospitalized depressed patients . Arch Gen Psychiatry 23:164-173, 1970.Crossref 45. Leyberg JT, Denmark JC: The treatment of depressive states with imipramine hydrochloride (Tofranil) . J Ment Sci 105:1123-1126, 1959. 46. Roulet N, Alvarez RR, Duffy JP, et al: Imipramine in depression: A controlled study . Am J Psychiatry 119:427-431, 1962. 47. Wilson IC, Vernon JT, Guin T, et al: A controlled study of treatment of depression . J Neuropsychiatry 4:331-337, 1963. 48. Robin AA, Harris JA: A controlled comparison of imipramine and electroplexy . J Ment Sci 108:217-219, 1962. 49. Rees L, Brown AC, Benaim S: A controlled trial of imipramine (Tofranil) in the treatment of severe depressive states . J Ment Sci 107:552-559, 1961. 50. Greenblatt M, Grosser GH, Wechsler H: A comparative study of selected antidepressant medications and EST . Am J Psychiatry 119:144-153, 1962. 51. Friedman C, DeMowbray M, Hamilton V: Imipramine (Tofranil) in depressive states . J Ment Sci 107:948-953, 1961. 52. Morris JB, Beck AT: The efficacy of antidepressant drugs: A review of research (1958 to 1972) . Arch Gen Psychiatry 30:667-674, 1974.Crossref 53. Abraham HC, Kanter VB, Rosen I, et al: A controlled clinical trial of imipramine (Tofranil) with outpatients . Br J Psychiatry 109:286-293, 1963.Crossref 54. Ainslie JD, Jones MB, Stiefel JR: Practical drug evaluation method: Imipramine in depressed outpatients . Arch Gen Psychiatry 12:368-373, 1965.Crossref 55. Jones MB, Ainslie JD: Value of placebo washout . Dis Nerv Syst 27:393-396, 1966. 56. Uhlenhuth EH, Park LC: The influence of medication (imipramine) and doctor in relieving depressed psychoneurotic outpatients . J Psychiatr Res 2:101-102, 1963.Crossref 57. Rickels K, Ward CH, Schut L: Different populations, different drug responses: A comparative study of two antidepressants, each used in two different patient groups . Am J Med Sci 247:328-335, 1964.Crossref 58. Bassa DM, Vora HD: Evaluation of efficacy of imipramine in depressive disorders: A double-blind study . Am J Psychiatry 121:1116-1117, 1965. 59. DiMascio A, Meyer RE, Stifler L: Effects of imipramine on individuals varying in level of depression . Am J Psychiatry 124:55-58, 1968. 60. Porter AM: Depressive illness in a general practice: A demographic study and a controlled trial of imipramine . Br Med J 1:773-778, 1970.Crossref 61. Schorer CE, Lowinger P, Dobie S: The real effect of imipramine, isocarboxazid and nialamide . Mich Med 65:1071-1075, 1966. 62. Rickels K, Hesbacher P, Downing RW: Differential drug effects in neurotic depression . Dis Nerv Syst 31:468-475, 1970. 63. Tetreault L: Comparative evaluation of antidepressant properites of opipramol, imipramine and a placebo in neurotic depression , in Lopez-Ibor JJ (ed): Proceedings of the Fourth World Congress of Psychiatry . Amsterdam, Excerpta Medica Foundation, 1968, Vol 3, pp 2027-2089. 64. Heller A, Zahourek R, Whittington HG: Effectiveness of antidepressant drugs: A triple-blind study comparing imipramine, desipramine, and placebo . Am J Psychiatry 127:1092-1095, 1971. 65. Agnew PC, Baran ID, Klapman HJ, et al: A clinical evaluation of four antidepressant drugs (Nardil, Tofranil, Marplan and Deprol) . Am J Psychiatry 118:160-162, 1961. 66. Karkalas Y, Lal H: Imipramine pamoate in hospitalized depressives: A double-blind comparison with placebo . Psychosomatics 11:107-111, 1970.Crossref 67. Wilson IC, Alltop L, Riley L: Tofranil in the treatment of post alcoholic depression . Psychosomatics 11:488-494, 1970.Crossref 68. Ruble PE: Psychic energizers in neurologically debilitated patients . J Neuropsychiatry 2 ( (suppl) ):S66-S68, 1972. 69. Robin AA, Langley GE: A controlled trial of imipramine . Br J Psychiatry 110:419-422, 1964.Crossref 70. Miller A, Baker EFW, Lewis D, et al: Imipramine, a clinical evaluation in a variety of settings: I. A controlled study of chronic depressed states treated with antidepressive drugs . Can Psychiatr Assoc J 5:150-160, 1960. 71. Mandell AJ, Markham CH, Tallman FF, et al: Motivation and ability to move . Am J Psychiatry 119:544-549, 1962. 72. Klein DF: Chlorpromazine-procyclidine combination, imipramine, and placebo in depressive disorders . Can Psychiatr Assoc J 11 ( (suppl) ):146-149, 1966. 73. Holdway V: Trial of imipramine . J Ment Sci 106:1443-1446, 1960. 74. Greenblatt M, Grosser GH, Wechsler H: Choice of somatic therapies in depression . Curr Psychiatr Ther 4:134-142, 1964. 75. Daneman EA: Imipramine in office management of depressive reactions (a double-blind clinical study) . Dis Nerv Syst 22:213-217, 1961. 76. DeSai RG, et al: Value of imipramine (Tofranil) in depression (a preliminary report) . J JJ Group Hosp Grant Med College 6:101-108, 1961. 77. Prange AJ Jr, McCurdy RL, Cochrane CM: The systolic blood pressure response of depressed patients to infused norepinephrine . J Psychiatr Res 5:1-13, 1967.Crossref 78. Ashby WR, Collins GH: A clinical trial of imipramine (Tofranil) on depressed patients . J Ment Sci 107:547-551, 1961. 79. Fink M, et al: Comparative studies of chlorpromazine and imipramine: I. Drug discriminating patterns , in Bradley PB, Flugel F, Hoch P (eds): Neuro-psychopharmacology . Amsterdam, Elsevier Publishing Co, 1961, pp 370-372. 80. Hohn R, Gross GM, Gross M, et al: A double-blind comparison of placebo and imipramine in the treatment of depressed patients in a state hospital . J Psychiatr Res 1:76-91, 1961.Crossref 81. Lovett JW, Doust DJ, Miller A, et al: Controlled assessment of antidepressant drugs, including Tofranil . Can Psychiatr Assoc J 4 ( (suppl) ):S190-S194, 1959. 82. DiFuria G, Marks JB: Methotrimeprazine as an adjunct to imipramine in depression . Russ Neuropsychiatry 17:210-219, 1963. 83. Friedman AS, Granick S, Cohen HW, et al: Imipramine (Tofranil) versus placebo in hospitalized psychotic depressives . J Psychiatr Res 4:13-36, 1966.Crossref 84. Fryer DG, Timberlake WH: A trial of imipramine (Tofranil) in depressed patients with chronic physical disease . J Chron Dis 16:173-178, 1963.Crossref 85. Sloane RB, Habib A, Batt UE: The use of imipramine (Tofranil) for depressive states in open ward settings of a general hospital . Can Med Assoc J 80:540-546, 1959. 86. Heimann H, Hursch L, Eisert HG, et al: Clinical and experimental demonstration of mood changes: Double-blind tests with imipramine, ketoimipramine and placebo . Arzneim Forsch 19:467-469, 1969. 87. Rothman T, Grayson H, Ferguson J: A comparative investigation of isocarboxazid and imipramine in depressive syndromes: A second report . J Neuropsychiatry 3:234-240, 1962. 88. Bellak L, Rosenberg S: Effects of antidepressant drugs on psychodynamics . Psychosomatics 7:106-114, 1966.Crossref 89. Hollister LE, Overall JE, Johnson M, et al: Controlled comparison of amitriptyline, imipramine, and placebo in hospitalized depressed patients . J Nerv Ment Dis 139:370-375, 1964.Crossref 90. Raskin A, Schulterbrandt JG, Boothe H, et al: Some suggestions for selecting appropriate depression subgroups for biochemical studies , in Williams TA, Katz MM, Shield JA Jr (eds): Recent Advances in the Psychobiology of the Depressive Illnesses . Washington, DC, National Institute of Mental Health, 1972, pp 315-329. 91. Raskin A, McKeon JJ: Super factors of psychopathology in hospitalized depressed patients . J Psychiatr Res 9:11-19, 1971.Crossref 92. Bunney WE Jr, Brodie RH, Murphy DL, et al: Studies of alpha-methyl-para-tyrosine, L-dopa, and L-tryptophan in depression and mania . Am J Psychiatry 127:872-880, 1971. 93. Carroll BJ, Mowbray RM, Davis B: Sequential comparison of L-tryptophan with ECT in severe depression . Lancet 1:967-969, 1970.Crossref 94. Dunner DL, Goodwin FK: Effect of L-tryptophan on brain serotonin metabolism in depressed patients . Arch Gen Psychiatry 26:364-366, 1972.Crossref 95. Klerman GL, Schildkraut JJ, Hasenbush LL, et al: Clinical experience with dihydroxyphenylalanine (dopa) in depression . J Psychiatr Res 1:289-297, 1963.Crossref 96. Pare CMB, Sandler MJ: A clinical and biochemical study of a trial of iproniazid in the treatment of depression . J Neurol Neurosurg Psychiatry 22:247-251, 1959.Crossref 97. Turner W, Merlis S: A clinical trial of pargyline and dopa in psychotic subjects . Dis Nerv Syst 25:538-541, 1964. 98. Goodwin FK, Murphy DL, Brodie HH, et al: L-dopa, catecholamines, and behavior: A clinical and biochemical study in depressed patients . Biol Psychiatry 2:341-366, 1970. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

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American Medical Association
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Copyright © 1975 American Medical Association. All Rights Reserved.
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0003-990X
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10.1001/archpsyc.1975.01760240093007
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Abstract

Abstract Thirty-four endogenous and 18 reactive, depressed patients (hospitalized and nonschizophrenic) were treated in a double-blind, crossover study of the hypothesis that rapid eye movement (REM) sleep reduction (by awakenings) relieves depression. In the endogenous group—but not in the reactive group—subjects deprived of REM sleep for three weeks improved significantly more than control subjects awakened from non-REM sleep. Therapeutic efficacy of REM sleep reduction appeared similar to reported efficacy of imipramine hydrochloride treatment of depression. Eight of nine endogenous patients, unimproved by REM sleep deprivation, did not improve with imipramine. Results suggested (1) that substantial REM sleep reduction has antidepressant activity, and (2) since imipramine and other drug antidepressants reduce REM sleep much more so than nonantidepressant drugs, that an antidepressant "mechanism" of drugs resides in their capacity to substantially reduce REM sleep. References 1. 29,32,34,38-44,46,48,50-86. 2. 40,71,75,77,78,80,82,84-86. 3. 29,32,34,41,42,46,48,61,66,67,69,70. 4. Dement WC: The effect of dream deprivation . Science 131:1705-1707, 1960.Crossref 5. Dement WC, Fisher C: Experimental interference with the sleep cycle . Can Psychiatr Assoc J 8:400-405, 1963. 6. Vogel GW: REM deprivation: III. Dreaming and psychosis . Arch Gen Psychiatry 18:312-329, 1968.Crossref 7. Vogel GW, Traub AC: REM deprivation: I. The effect on schizophrenic patients . Arch Gen Psychiatry 18:287-300, 1968.Crossref 8. Vogel GW, Traub AC: The effects of REM deprivation on psychotically depressed patients . Psychophysiol 4:382, 1968. 9. Vogel GW, Traub AC: Further studies on REM deprivation of depressed patients . Psychophysiol 5:239, 1968. 10. Vogel GW, Traub AC, Ben-Horin P, et al: REM deprivation: II. The effects on depressed patients . Arch Gen Psychiatry 18:301-311, 1968.Crossref 11. Hishikawa Y, Nakai K, Ida H, et al: The effect of imipramine, desmethylimipramine and chloropromazine on the sleepwakefulness cycle of the cat . Electroencephalogr Clin Neurophysiol 19:518-521, 1965.Crossref 12. Ryba P, Engelwardt DM, Dreedman W, et al: Effects of imipramine on sleep patterns of psychiatric patients. Read before the Association for the Psychophysiological Study for Sleep, Gainesville, Fla, 1966. 13. Hartmann E: Pharmacological studies in man: Phenobarbital (Nembutal), amitryptyline (Elavil), chlordiazepoxide (Librium), and Ro5-6901 (Dalmane) . Psychophysiol 4:391, 1968. 14. Le Gassicke J, Ashcroft GW, Eccleston D, et al: The clinical state, sleep and amine metabolism of a tranylcypromine (parnate) addict . Br J Psychiatry 111:357-364, 1965.Crossref 15. Jouvet M: Mechanisms of the states of sleep: A neuropharmacological approach , in Kety SS, Evarts FV, Williams HL (eds): Sleep and Altered States of Consciousness . Baltimore, Williams & Wilkins Co, 1967, pp 86-126. 16. Cohen H, Dement WC, Duncan R: The effect of electroconvulsive shock on REM sleep deprivation in the cat. Read before the Association for the Psychophysiological Study for Sleep, Gainesville, Fla, 1966. 17. Cohen H, Dement WC: Suppression of rapid eye movement sleep in following electroconvulsive shock. Read before the APSS, Gainesville, Fla, 1966. 18. Zarcone J, Gulevich G, Dement W: Some relationships between REM sleep and electrically induced convulsions. Read before the APSS, Gainesville, Fla, 1966. 19. Hartmann E: Reserpine: Its effect on the sleep-dream cycle in man . Psychopharmacol 9:246-247, 1966.Crossref 20. Dement WC: Recent studies on the biological role of REM sleep . Am J Psychiatry 122:404-408, 1965. 21. Vogel GW, Thompson FC Jr, Boatwright MH: The effect of REM deprivation on depression, abstracted . Psychophysiol 9:138, 1972. 22. Vogel GW, Thompson FC, Thurmond A, et al: The effect of REM deprivation on depressive syndromes , in Chase MH, Stern WC, Walter PL (eds): Sleep Research . Los Angeles, Brain Information Service, Brain Research Institute, University of California, 1972, vol 1, p 167. 23. Vogel GW, Thompson FC, Thurmond A, et al: The effect of REM deprivation on depression . Psychosomatics 14:104-107, 1973.Crossref 24. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 23:56-62, 1960.Crossref 25. Kiloh LG, Garside RF: The independence of neurotic depression and endogenous depression . Br J Psychiatry 109:451-463, 1963.Crossref 26. Rosenthal SH, Klerman GL: Content and consistency in the endogenous depressive pattern . Br J Psychiatry 122:471-484, 1966.Crossref 27. Mendels J, Cochrane C: The nosology of depression: The endogenous-reactive concept . Am J Psychiatry 124 ( (suppl) ):1-11, 1968. 28. Rechtschaffen A, Kales A (eds): A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects . National Institutes of Health, Neurological Information Network, Bethesda, Md, 1968. 29. Zung WWK: A self-rating depression scale . Arch Gen Psychiatry 12:63-70, 1965.Crossref 30. Wechsler D: Wechsler Adult Intelligence Scale . New York, The Psychological Corp, 1955. 31. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co Inc, 1956. 32. Clinical Psychiatry Committee of the British Medical Research Council: Clinical trial of the treatment of depressive illness . Br Med J 1:881-886, 1965.Crossref 33. Prusoff BA, Klerman GL, Paykel ES: Concordance between clinical assessments and patients' self-report in depression . Arch Gen Psychiatry 26:546-552, 1972.Crossref 34. Carroll BJ, Fielding JM, Blashki TG: Depression rating scales . Arch Gen Psychiatry 28:361-366, 1973.Crossref 35. Overall JE, Hollister LE, Porkorny AD, et al: Drug therapy in depression, controlled evaluation of imipramine, isocarboxazid, dextroamphetamine—amobarbital and placebo . Clin Pharmacol Ther 3:16-22, 1962. 36. Friedman AS: Minimal effects of severe depression on cognitive functioning . J Abnorm Soc Psychol 69:237-243, 1964.Crossref 37. Kenning IS, Richardson NL, Tucker FG: The treatment of depressive states with imipramine hydrochloride . Can Psychiatr Assoc J 5:60-64, 1960. 38. Akindele MO, Evans JI, Oswald I: Monoamine oxidase inhibitors, sleep and mood . Electroencephalogr Clin Neurophysiol 29:47-56, 1970.Crossref 39. Wyatt RJ, Fram DH, Kupfer DJ, et al: Total prolonged drug-induced REM sleep suppression in anxious-depressed patients . Arch Gen Psychiatry 24:145-155, 1971.Crossref 40. Dunleavy DLF, Oswald I: Phenelzine, mood response, and sleep . Arch Gen Psychiatry 28:353-356, 1973.Crossref 41. Wittenborn JR, Plante M, Burgess F, et al: A comparison of imipramine, electroconvulsive therapy and placebo in the treatment of depressions . J Nerv Ment Dis 135:131-137, 1962.Crossref 42. Ball JRB, Kiloh LG: A controlled trial of imipramine in treatment of depressive states . Br Med J 2:1052-1055, 1959.Crossref 43. Greenblatt M, Grosser GH, Wechsler H: Differential response of hospitalized depressed patients to somatic therapy . Am J Psychiatry 120:935-943, 1964. 44. Raskin A, Schulterbrandt JG, Reatig N, et al: Differential response to chlorpromazine, imipramine, and placebo: A study of subgroups of hospitalized depressed patients . Arch Gen Psychiatry 23:164-173, 1970.Crossref 45. Leyberg JT, Denmark JC: The treatment of depressive states with imipramine hydrochloride (Tofranil) . J Ment Sci 105:1123-1126, 1959. 46. Roulet N, Alvarez RR, Duffy JP, et al: Imipramine in depression: A controlled study . Am J Psychiatry 119:427-431, 1962. 47. Wilson IC, Vernon JT, Guin T, et al: A controlled study of treatment of depression . J Neuropsychiatry 4:331-337, 1963. 48. Robin AA, Harris JA: A controlled comparison of imipramine and electroplexy . J Ment Sci 108:217-219, 1962. 49. Rees L, Brown AC, Benaim S: A controlled trial of imipramine (Tofranil) in the treatment of severe depressive states . J Ment Sci 107:552-559, 1961. 50. Greenblatt M, Grosser GH, Wechsler H: A comparative study of selected antidepressant medications and EST . Am J Psychiatry 119:144-153, 1962. 51. Friedman C, DeMowbray M, Hamilton V: Imipramine (Tofranil) in depressive states . J Ment Sci 107:948-953, 1961. 52. Morris JB, Beck AT: The efficacy of antidepressant drugs: A review of research (1958 to 1972) . Arch Gen Psychiatry 30:667-674, 1974.Crossref 53. Abraham HC, Kanter VB, Rosen I, et al: A controlled clinical trial of imipramine (Tofranil) with outpatients . Br J Psychiatry 109:286-293, 1963.Crossref 54. Ainslie JD, Jones MB, Stiefel JR: Practical drug evaluation method: Imipramine in depressed outpatients . Arch Gen Psychiatry 12:368-373, 1965.Crossref 55. Jones MB, Ainslie JD: Value of placebo washout . Dis Nerv Syst 27:393-396, 1966. 56. Uhlenhuth EH, Park LC: The influence of medication (imipramine) and doctor in relieving depressed psychoneurotic outpatients . J Psychiatr Res 2:101-102, 1963.Crossref 57. Rickels K, Ward CH, Schut L: Different populations, different drug responses: A comparative study of two antidepressants, each used in two different patient groups . Am J Med Sci 247:328-335, 1964.Crossref 58. Bassa DM, Vora HD: Evaluation of efficacy of imipramine in depressive disorders: A double-blind study . Am J Psychiatry 121:1116-1117, 1965. 59. DiMascio A, Meyer RE, Stifler L: Effects of imipramine on individuals varying in level of depression . Am J Psychiatry 124:55-58, 1968. 60. Porter AM: Depressive illness in a general practice: A demographic study and a controlled trial of imipramine . Br Med J 1:773-778, 1970.Crossref 61. Schorer CE, Lowinger P, Dobie S: The real effect of imipramine, isocarboxazid and nialamide . Mich Med 65:1071-1075, 1966. 62. Rickels K, Hesbacher P, Downing RW: Differential drug effects in neurotic depression . Dis Nerv Syst 31:468-475, 1970. 63. Tetreault L: Comparative evaluation of antidepressant properites of opipramol, imipramine and a placebo in neurotic depression , in Lopez-Ibor JJ (ed): Proceedings of the Fourth World Congress of Psychiatry . Amsterdam, Excerpta Medica Foundation, 1968, Vol 3, pp 2027-2089. 64. Heller A, Zahourek R, Whittington HG: Effectiveness of antidepressant drugs: A triple-blind study comparing imipramine, desipramine, and placebo . Am J Psychiatry 127:1092-1095, 1971. 65. Agnew PC, Baran ID, Klapman HJ, et al: A clinical evaluation of four antidepressant drugs (Nardil, Tofranil, Marplan and Deprol) . Am J Psychiatry 118:160-162, 1961. 66. Karkalas Y, Lal H: Imipramine pamoate in hospitalized depressives: A double-blind comparison with placebo . Psychosomatics 11:107-111, 1970.Crossref 67. Wilson IC, Alltop L, Riley L: Tofranil in the treatment of post alcoholic depression . Psychosomatics 11:488-494, 1970.Crossref 68. Ruble PE: Psychic energizers in neurologically debilitated patients . J Neuropsychiatry 2 ( (suppl) ):S66-S68, 1972. 69. Robin AA, Langley GE: A controlled trial of imipramine . Br J Psychiatry 110:419-422, 1964.Crossref 70. Miller A, Baker EFW, Lewis D, et al: Imipramine, a clinical evaluation in a variety of settings: I. A controlled study of chronic depressed states treated with antidepressive drugs . Can Psychiatr Assoc J 5:150-160, 1960. 71. Mandell AJ, Markham CH, Tallman FF, et al: Motivation and ability to move . Am J Psychiatry 119:544-549, 1962. 72. Klein DF: Chlorpromazine-procyclidine combination, imipramine, and placebo in depressive disorders . Can Psychiatr Assoc J 11 ( (suppl) ):146-149, 1966. 73. Holdway V: Trial of imipramine . J Ment Sci 106:1443-1446, 1960. 74. Greenblatt M, Grosser GH, Wechsler H: Choice of somatic therapies in depression . Curr Psychiatr Ther 4:134-142, 1964. 75. Daneman EA: Imipramine in office management of depressive reactions (a double-blind clinical study) . Dis Nerv Syst 22:213-217, 1961. 76. DeSai RG, et al: Value of imipramine (Tofranil) in depression (a preliminary report) . J JJ Group Hosp Grant Med College 6:101-108, 1961. 77. Prange AJ Jr, McCurdy RL, Cochrane CM: The systolic blood pressure response of depressed patients to infused norepinephrine . J Psychiatr Res 5:1-13, 1967.Crossref 78. Ashby WR, Collins GH: A clinical trial of imipramine (Tofranil) on depressed patients . J Ment Sci 107:547-551, 1961. 79. Fink M, et al: Comparative studies of chlorpromazine and imipramine: I. Drug discriminating patterns , in Bradley PB, Flugel F, Hoch P (eds): Neuro-psychopharmacology . 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Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1975

References