Effect of imipramine on depression and immune status in a sample of men with HIV infection

Article Abstract:

Depressive disorders have been reported in individuals who are infected with the human immunodeficiency virus (HIV), the agent that causes AIDS (acquired immunodeficiency syndrome). Thus far, no research has reported on the effectiveness of antidepressants in these patients, or on how these treatments affect the immune status of HIV-infected individuals. The results of previous studies have been inconsistent regarding the effects of depression on the immune status of these patients; some studies have reported it influences immune status and others have observed no effects. Eleven men who were HIV-positive and were also diagnosed with major depression were treated with imipramine. Observations were made of the subjects, who had no prior history of major depression, over a six-month period. The patients took a fixed dosage of the medication, and periodic measurements of T4 cell counts were made as an index of immune status. Of the nine patients who completed 12 weeks of treatment, eight (89 percent) responded to imipramine treatment for depression. The decline of T4 cells from baseline measurements was comparable to that in HIV-infected individuals with major depression who were not treated for depression, as reported in another study. These results indicate that imipramine had no adverse effects on the immune function of the patients; the HIV-related condition did not worsen. It is believed that these data constitute preliminary evidence that treatment with imipramine for depression in HIV-positive patients is safe and effective. Further research is underway to extend and confirm these results. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, HIV patients

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Tranylcypromine versus imipramine in anergic bipolar depression

Article Abstract:

Little has been written about the treatment of bipolar disorder (also called manic-depressive illness) in its acute, depressed phase; bipolar disorder involves periods of depression and excessive excitement. Often, depressed bipolar patients are treated as other depressives are, with tricyclic antidepressants. In some cases these are prescribed in addition to lithium, which is the treatment of choice for maintaining mood stability in bipolar patients. In recent years, there has been increased attention paid to monoamine oxidase inhibitors (MAOIs) as an alternate treatment for depression in bipolar disorder and in the treatment of atypical (psychotic) depression as well. Tranylcypromine, an MAOI, has been found to be useful either alone or combined with lithium in bipolar disorder, and particularly in the depressed phase of bipolar disorder. In a controlled comparison study of tranylcypromine and a standard tricyclic antidepressant, imipramine, for the treatment of bipolar depression, a total of 56 outpatients were divided into two treatment groups (one for each drug). Subjects were followed for a total of 16 weeks. A significantly greater number of patients in the imipramine group than in the tranylcypromine group (seven versus two) were withdrawn from the study due to side effects of the medication, and of the remaining patients, a significantly greater number responded to acute treatment in the tranylcypromine group than in the imipramine group (21 versus 10, respectively). Tranylcypromine was therefore more effective than imipramine in the treatment of depressed, bipolar patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bipolar disorder, Tranylcypromine

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Adjunctive imipramine maintenance treatment in schizophrenic patients with remitted postpsychotic depression

Article Abstract:

Schizophrenia is a psychiatric disorder typically involving delusions, hallucinations, and inappropriate affect (mood). Some patients with schizophrenia or related schizoaffective disorders have symptoms of depression after other symptoms such as psychosis have resolved; this type of depression is known as postpsychotic depression. These individuals may benefit from maintenance treatment with antidepressant medications such as imipramine. Ten patients who had a history of postpsychotic depression which was relieved by imipramine participated in this study. For six months, four subjects were continued on imipramine as part of a three-drug program and six were gradually tapered off imipramine while continuing the other medications. A placebo was used to replace the imipramine. All the patients taken off imipramine experienced a relapse of depression, while only one of the four continued on imipramine for one year had a depressive relapse. The results suggest that imipramine maintenance therapy was effective against depression in these patients who had previously responded well to the drug. Antidepressants have been reported to exacerbate the psychosis of schizophrenics, but this did not happen in these patients. The reverse occurred, where three of six patients who were tapered off imipramine had increased psychotic symptoms.

Complications and side effects, Antidepressants, Schizophrenia, Schizophrenics

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