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PubMed1985

Tritiated imipramine binding to platelets in manic subjects.

We studied 21 patients with bipolar affective disorder and 25 healthy controls in order to determine if tritiated imipramine binding to platelets distinguished the manic from the depressed phase of bipolar disorder. Depressed patients had a significantly lower mean Bmax value (754 +/- 149 fmole/mg protein) than the manic and control groups (1112 +/- 248 and 1237 +/- 201 fmole/mg protein, respectively), which did not differ from each other. These differences could not be attributed to differences in age, sex, menopausal status, the presence of psychotic features or medication history among the subject groups. These findings confirm that decreased imipramine binding to platelets is a state marker for bipolar depression and not a trait marker of bipolar disorder.

Adult↗
PubMedDate not supplied

Platelet [3H]imipramine binding in depressed patients and its circadian variations in healthy controls.

Platelet [3H]imipramine binding was determined in 28 patients with major depression, 11 with bipolar disorders, and 28 healthy controls. The mean maximum number of binding sites (Bmax) in depressed patients was significantly lower than in healthy controls. A significant negative correlation was found between the Bmax values and the total scores of the 17-item Hamilton depression rating scale in major depression. Our results suggest that the Bmax values in major depression may be related to severity of depression. There were significant circadian variations in the Bmax values of [3H]imipramine binding on human platelets from six healthy controls. The mean Bmax values were significantly low in the dark phase and high in the light phase.

Adult↗
PubMedDate not supplied

Clomipramine for panic disorder: I. The first 10 weeks of a long-term comparison with imipramine.

Clomipramine and imipramine treatments were compared in a sample of 152 panic disorders. Diagnosis was according to the positive criteria of DSM-III-R, but without exclusion of comorbid affective or personality disorders. The 2-year design provides non-blind treatment under typical clinical practice conditions, and it includes random assignment, periodic assessment with standardized measures, and comparable, flexible drug dosages. Findings on six outcome measures in the first 59 cases to complete 10 weeks showed both tricyclics to be markedly and equally effective for blocking panic attacks, alleviating phobic avoidance, and reducing nonspecific aspects of anxiety. Clomipramine's predominantly serotonergic action seemed not to determine a different action spectrum. During the first 2 weeks, clomipramine was significantly and unexpectedly superior to imipramine in both antipanic and antiphobic actions. These results require replication under double-blind conditions.

Adolescent↗
PubMedDate not supplied

Prediction of response of chronic depression to imipramine.

We had previously reported that imipramine was superior to placebo for the treatment of chronic depression. As a part of that study, we subsequently investigated clinical and demographic variables which might be associated with favorable or poor outcome for treatment with imipramine or placebo. Results are reported herein. Eight-six patients were entered and 53 completed an 8-week protocol. Outcome was assessed based on a 6-week, double-blind treatment phase, which followed a 2-week, single-blind placebo phase. Outcome was not found to significantly relate to demographic variables, severity or course of depression, diagnostic subtype, symptom profile, or DST results. Some modest associations were found between 'neurotic' personality traits and poor outcome. Results are discussed and compared with prior studies of prediction of tricyclic antidepressant response in both acute and chronic depressions.

Adult↗
PubMedDate not supplied

Onset of response in relation to outcome in depressed outpatients with placebo and imipramine.

We have retrospectively analyzed the results of the pooled data from three 6-week placebo controlled double blind phase III clinical trials, initially designed to assess the efficacy of newer antidepressants, in order to study the relationship of early onset improvement with later outcome in 145 depressed outpatients receiving placebo (n = 98) or imipramine (n = 47). The early onset response was seen in a subgroup of subjects receiving either imipramine or placebo and appeared to be independent of treatment assignment. Furthermore, the early onset response predicted outcome for the duration of the trial and was not selective as defined by specific changes in subscales measuring insomnia, anxiety or endogenous features. Exclusion of early onset responders resulted in the augmentation of the difference in outcome with drug and placebo. We recommend that future placebo controlled trials assessing therapeutic efficacy of active treatments in depressed outpatients take into account the early onset response in the analysis of results.

Adult↗
PubMedDate not supplied

Platelet serotonin uptake and 3H-imipramine binding in panic disorder.

Platelet serotonin uptake and 3H-imipramine binding were measured in eight patients with panic disorders and nine controls. The Vmax of serotonin uptake was significantly elevated in patients compared to controls (77 +/- 14 vs. 50 +/- 4 pmol/10(8) platelets/min; P less than 0.05) while Km values were not different (1.46 +/- 0.41 vs. 1.24 +/- 0.20 microM). 3H-Imipramine binding to ruptured platelet membranes was not significantly different between patients and controls for either Bmax (395 +/- 71 vs. 412 +/- 107 fmol/mg protein) or Kd (0.90 +/- 0.18 vs. 1.09 +/- 0.30 nM). The implications for a serotonergic dysfunction in panic disorders are discussed.

Adult↗
PubMedDate not supplied

Effect of imipramine treatment on the prolactin response to fenfluramine and placebo challenge in depressed patients.

As an index of central serotonergic function, plasma prolactin response to fenfluramine (60 mg orally) and placebo challenge was examined in 10 depressed patients before and after treatment with imipramine 200 mg/day for 3 weeks. Although baseline prolactin levels were not altered by imipramine, the prolactin response to fenfluramine was significantly (P = 0.01) increased compared to the response in the untreated state. The response to placebo was also enhanced but this effect was of lesser magnitude and not statistically significant. These findings complement previous reports and suggest that tricyclic antidepressant treatment enhances serotonergically mediated neuroendocrine responses.

Adult↗
PubMed1991

Platelet tritiated imipramine binding in patients suffering from mania.

Platelet imipramine binding was measured in 16 patients suffering from DSM-IIIR mania and compared with binding values reported in depressed and healthy control subjects recruited in a parallel study (Ellis et al., 1990). Binding levels in the manic group did not differ from control values, but were higher than in the depressed group. Within the manic group, binding did not differ with severity of illness or the presence of depressive symptoms but there was a trend to lower values (comparable to those in the depressed group) with increasing duration of illness. This raises the possibility that changes in imipramine binding in depression and mania may be similar, consistent with the permissive hypothesis of serotonin function.

Bipolar Disorder↗
PubMedDate not supplied

Imipramine an effective treatment for illness phobia.

Ten subjects with illness phobia were treated with imipramine for 8 weeks. All of the eight subjects who remained on the drug for 4 weeks or more reported at least moderate improvement. Overstimulatory reactions occurred in four subjects causing two to discontinue medication. Imipramine appears to be a potentially useful treatment for this subtype of hypochondriasis.

Adult↗
PubMed1992

Brofaromine in major depressed patients: a controlled clinical trial versus imipramine and open follow-up of up to one year.

In an 8-week controlled double-blind clinical trial with a total of 216 patients Brofaromine was found to be superior to Imipramine with regard to efficacy (Hamilton Depression Scale, von Zerssen self-rating scale, global evaluation) and tolerability (adverse experiences, global evaluation). Mean daily dosages were 93.1 mg/day in the Brofaromine group and 92 mg/day in the Imipramine Group. No tyramine reduced diet had to be observed. Long-term efficacy and tolerability also proved to be good in an open follow-up in the Brofaromine group.

Adult↗
PubMed1994

Do depressed patients with higher pretreatment stress levels respond better to cognitive therapy than imipramine?

Forty-eight unipolar depressed patients were randomly assigned to 12 weeks of treatment with either imipramine (IMI) (n = 32) or cognitive therapy (CT) (n = 16). Prior to treatment assignment, all patients were rated for severity of a variety of psychosocial stressors. The interaction effect between pretreatment stress and type of treatment, CT or IMI, on symptom improvement was evaluated. We hypothesized that patients with greater pretreatment stress would respond better to cognitive therapy. Patients treated with either CT or IMI showed equivalent reductions of depressive symptoms. There was no interaction effect between pretreatment stress and type of treatment on improvement of depressive symptoms. Based on this preliminary study it does not appear that depressed patients with higher pretreatment levels of stress respond better to cognitive therapy than they do to imipramine.

Adult↗
PubMed1994

Anxiety psychopathology predictive of outcome in patients with panic disorder and depression treated with imipramine, alprazolam and placebo.

This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week, placebo-controlled trial of alprazolam and imipramine (n = 126). Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment. Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4. At endpoint, the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance. This relationship was not evident for completers, suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced.

Adult↗
PubMed1984

Seasonal variation in platelet 3H-imipramine binding: comparable values in control and depressed populations.

Recent findings of reduced 3H-imipramine binding in platelets of depressed patients compared to healthy controls have been proposed as a biological marker of depression. However, these studies failed to consider the possible occurrence of seasonal variation in the binding characteristics. Our results show a highly significant seasonal variation in platelet 3H-imipramine binding which occurs in both normal and depressed populations. Furthermore, when annual rhythms are taken into account, there is no difference in the binding parameters in the two populations.

Adult↗
PubMed1985

Lower 3H-imipramine binding in platelets from untreated depressed patients compared to healthy controls.

3H-Imipramine binding in platelets was measured in 63 severely depressed hospitalized patients, who had been drug free (with the exception of moderate doses of benzodiazepines) for at least 1 month, and in 53 healthy control subjects of comparable age and sex distribution. Bmax of 3H-imipramine binding was significantly lower in the depressed subjects (1012 +/- SD 295 vs. 1123 +/- SD 178 fmole/mg protein). Depressed patients who had attempted suicide by violent means tended to have higher Bmax than nonviolent attempters.

Adult↗
PubMed1985

Variation in human platelet 3H-imipramine binding.

Platelet 3H-imipramine binding values from 45 normal controls and 20 depressed subjects were collected over a 2-year period. During this time, wide inter-individual variations in the affinity constant (Kd) and maximal number of binding sites (Bmax) were observed in the control population; however, we failed to observe a seasonal change in platelet 3H-imipramine binding. The Kd and Bmax values of depressed subjects were not significantly different from those of controls.

Binding Sites↗
PubMed1986

Chronic imipramine treatment and weight gain.

A study of weight change in subjects treated with imipramine was performed on recurrent depressive outpatients. The patients (n = 52) were treated with imipramine (200-250 mg/day) and psychotherapy for 16 weeks. Each individual was weighed upon entry to the study (drug-free) and then weekly thereafter for 16 weeks. Of the 44 women (85%) and 8 men (15%) in the study, 60% of the total group had a weight gain or loss less than 5 pounds (mean = 1.1 pounds) over this time. A weight gain of 6-10 pounds was observed in 19% of subjects, while 9% of the group gained 11-15 pounds. Only 6% (3 subjects) gained more than 15 pounds. Three subjects (6%) lost 6-10 pounds. No correlations were observed between a change in weight and the subject's age, sex, prior weight, or response to medication.

Adult↗
PubMed1986

3H-imipramine binding in blood platelets of schizophrenic patients.

3H-Imipramine binding was studied in the blood platelets of 51 unmedicated chronic schizophrenic patients. Univariate analyses of log-transformed data revealed that Bmax was significantly lower in schizophrenic patients than normal volunteers; Kd was nonsignificantly higher in the schizophrenics. A multivariate analysis of variance indicated the Kd and Bmax both differ significantly between normal controls and schizophrenic patients in the direction of increased Kd and decreased Bmax in the schizophrenics. These results indicate that decreased platelet imipramine binding is not specific for major depression.

Adult↗
PubMed1986

3H-imipramine binding in depressed elderly: relationship to family history and clinical response.

Platelet 3H-imipramine binding (Bmax) was determined in 34 elderly (mean age 64.8) unipolar depressed outpatients who were being treated with either nortriptyline or interpersonal psychotherapy for 10 to 16 weeks, and in nondepressed elderly controls. Bmax values were decreased in the depressed group. In addition, Bmax values were depressed further in subjects with a history of depression in first degree relatives. Good clinical response with either nortriptyline or psychotherapy was associated with lower Bmax compared to those subjects who had a poorer response to treatment. Treatment nonresponders and those with a negative family history of depression had Bmax values that were somewhat decreased but not significantly different from controls. This study extends to the elderly the potential applicability of platelet 3H-imipramine binding as a marker of depressive illness, and proposes a predictor for treatment response in elderly unipolar depressed patients.

Aged↗