LITHIUM AND DESIPRAMINE VERSUS DESIPRAMINE ALONE IN THE TREATMENT OF SEVERE MAJOR DEPRESSION - A PRELIMINARY-STUDY

Improvement following lithium augmentation is well-documented in depre ssed patients resistant to tricyclic antidepressants. However, respons e latency to lithium augmentation is extremely variable, suggesting ot her mechanisms may be involved. To evaluate whether long-term tricycli c treatment is necessary for lithium augmentation's effect, the rapidi ty 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 rand omized to double-blind, placebo-controlled treatment with either lithi um + desipramine or placebo + desipramine for 4 weeks. Response criter ia were based on Hamilton Depression Rating Scale scores and global im provement. 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 monot herapy (P < 0.042). These preliminary data suggest that lithium + desi pramine may have some efficacy in severely depressed patients. Further studies with larger samples are needed to confirm these findings. Int Clin Psychopharmacol 13:191-198 (C) 1998 Lippincott Williams & Wilkin s.