THE PATTERN OF PHYSICAL SYMPTOM CHANGES IN MAJOR DEPRESSIVE DISORDER FOLLOWING TREATMENT WITH AMITRIPTYLINE OR IMIPRAMINE

The study describes a sequential analysis of depression-related physic al symptoms and their relationship to imipramine and amitriptyline pla sma levels over 4 weeks of treatment in 79 unipolar and bipolar patien ts hospitalized for major depressive disorder. Insomnia diminished in all patients after 2 weeks of drug administration. After 4 weeks, the sleep of patients whose depressive disorder had significantly improved was nearly normal, whereas patients who remained depressed showed con tinued sleep impairment. Reductions in loss of appetite, weight and se xual interest paralleled mood improvement. Tricyclic plasma levels sig nificantly correlated with improved sleep. The findings suggest a clos e link between depressed mood and physical symptoms during recovery fr om major depressive disorder.